Provider Demographics
NPI:1609045293
Name:ST TAMMANY FIRE DISTRICT #1
Entity Type:Organization
Organization Name:ST TAMMANY FIRE DISTRICT #1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:TRICE
Authorized Official - Last Name:SHOULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN NREMT-P
Authorized Official - Phone:985-646-4861
Mailing Address - Street 1:34780 S RANGE RD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-6833
Mailing Address - Country:US
Mailing Address - Phone:985-646-4861
Mailing Address - Fax:
Practice Address - Street 1:1358 CORPORATE SQUARE DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3153
Practice Address - Country:US
Practice Address - Phone:985-649-3665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport