Provider Demographics
NPI:1497815369
Name:LONE JACK COMMUMITY FIRE PROTECTION
Entity Type:Organization
Organization Name:LONE JACK COMMUMITY FIRE PROTECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-697-2018
Mailing Address - Street 1:107 W MAIN
Mailing Address - Street 2:PO BOX 50
Mailing Address - City:LONE JACK
Mailing Address - State:MO
Mailing Address - Zip Code:64070-0050
Mailing Address - Country:US
Mailing Address - Phone:816-697-2018
Mailing Address - Fax:816-697-3790
Practice Address - Street 1:107 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LONE JACK
Practice Address - State:MO
Practice Address - Zip Code:64070-9761
Practice Address - Country:US
Practice Address - Phone:816-697-2018
Practice Address - Fax:816-697-3790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO095303341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance