Provider Demographics
NPI:1437260817
Name:CITY OF SOUTH JORDAN
Entity Type:Organization
Organization Name:CITY OF SOUTH JORDAN
Other - Org Name:SOUTH JORDAN CITY FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-910-6601
Mailing Address - Street 1:1600 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8697
Mailing Address - Country:US
Mailing Address - Phone:801-254-0948
Mailing Address - Fax:801-254-8356
Practice Address - Street 1:10758 S REDWOOD ROAD
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8507
Practice Address - Country:US
Practice Address - Phone:801-254-0948
Practice Address - Fax:801-254-8356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1858L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT81703OtherPEHP
UT000009127Medicare PIN