Provider Demographics
NPI:1477953891
Name:GREEN VALLEY FIRE DISTRICT
Entity Type:Organization
Organization Name:GREEN VALLEY FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:WUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-625-9400
Mailing Address - Street 1:1285 S. CAMINO ENCANTO
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622
Mailing Address - Country:US
Mailing Address - Phone:520-625-9400
Mailing Address - Fax:
Practice Address - Street 1:898 N. CAMPBELL
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629
Practice Address - Country:US
Practice Address - Phone:520-399-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty