Provider Demographics
NPI:1437216405
Name:KEY WEST FIRE DEPARTMENT
Entity Type:Organization
Organization Name:KEY WEST FIRE DEPARTMENT
Other - Org Name:KEY WEST FIRE AND EMS ASSOCIATION
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:563-557-9556
Mailing Address - Street 1:10640 LAKE ELEANOR ROAD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-8904
Mailing Address - Country:US
Mailing Address - Phone:563-557-9556
Mailing Address - Fax:563-557-9556
Practice Address - Street 1:10640 LAKE ELEANOR ROAD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-8904
Practice Address - Country:US
Practice Address - Phone:563-557-9556
Practice Address - Fax:563-557-9556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23164003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0442061Medicaid
IA0442061Medicaid