Provider Demographics
NPI:1568574846
Name:WASATCH COUNTY FIRE PROTECTION SPECIAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:WASATCH COUNTY FIRE PROTECTION SPECIAL SERVICE DISTRICT
Other - Org Name:WASATCH COUNTY FIRE DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ERNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-940-9636
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:10420 NORTH JORDANELLE BLVD
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032
Mailing Address - Country:US
Mailing Address - Phone:435-940-9636
Mailing Address - Fax:435-654-9729
Practice Address - Street 1:10420 NORTH JORDANELLE BLVD
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032
Practice Address - Country:US
Practice Address - Phone:435-940-9636
Practice Address - Fax:435-654-9729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2601L341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========010Medicaid
UT000090585Medicare PIN