Provider Demographics
NPI:1588831267
Name:QUARTZSITE FIRE DISTRICT
Entity Type:Organization
Organization Name:QUARTZSITE FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:CEP
Authorized Official - Phone:928-927-6556
Mailing Address - Street 1:PO BOX 1889
Mailing Address - Street 2:
Mailing Address - City:QUARTZSITE
Mailing Address - State:AZ
Mailing Address - Zip Code:85346-1889
Mailing Address - Country:US
Mailing Address - Phone:928-927-6556
Mailing Address - Fax:928-927-4277
Practice Address - Street 1:70 E TYSON STREET
Practice Address - Street 2:
Practice Address - City:QUARTZSITE
Practice Address - State:AZ
Practice Address - Zip Code:85346-1889
Practice Address - Country:US
Practice Address - Phone:928-927-6556
Practice Address - Fax:928-927-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251K00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency