Provider Demographics
NPI:1427570753
Name:BUCKSKIN FIRE DISTRICT
Entity Type:Organization
Organization Name:BUCKSKIN FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRAINING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLERIN
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:928-667-3321
Mailing Address - Street 1:8500 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:AZ
Mailing Address - Zip Code:85344-7001
Mailing Address - Country:US
Mailing Address - Phone:928-667-3321
Mailing Address - Fax:928-667-3431
Practice Address - Street 1:8500 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344-7001
Practice Address - Country:US
Practice Address - Phone:928-667-3321
Practice Address - Fax:928-667-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty