Provider Demographics
NPI:1558832865
Name:BOUSE VOLUNTEER FIRE DISTRICT
Entity Type:Organization
Organization Name:BOUSE VOLUNTEER FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-851-2648
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:BOUSE
Mailing Address - State:AZ
Mailing Address - Zip Code:85325-0155
Mailing Address - Country:US
Mailing Address - Phone:928-851-2648
Mailing Address - Fax:928-851-1140
Practice Address - Street 1:27716 FRAME AVENUE
Practice Address - Street 2:
Practice Address - City:BOUSE
Practice Address - State:AZ
Practice Address - Zip Code:85325
Practice Address - Country:US
Practice Address - Phone:928-851-2648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-13
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport