Provider Demographics
NPI:1598385783
Name:CITY OF GOODYEAR
Entity Type:Organization
Organization Name:CITY OF GOODYEAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BATTALION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEINSCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-688-4877
Mailing Address - Street 1:1900 N CIVIC SQ
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2012
Mailing Address - Country:US
Mailing Address - Phone:623-932-2300
Mailing Address - Fax:
Practice Address - Street 1:14455 W VAN BUREN ST # E102
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-9209
Practice Address - Country:US
Practice Address - Phone:623-688-4877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty