Provider Demographics
NPI:1619914033
Name:CITY OF DOUGLAS
Entity Type:Organization
Organization Name:CITY OF DOUGLAS
Other - Org Name:CITY OF DOUGLAS FIRE AND AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDROZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-419-7319
Mailing Address - Street 1:425 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85607-2308
Mailing Address - Country:US
Mailing Address - Phone:520-364-2481
Mailing Address - Fax:520-364-5261
Practice Address - Street 1:1400 E 10TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-2308
Practice Address - Country:US
Practice Address - Phone:520-364-2481
Practice Address - Fax:520-364-5261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZEMS 25153416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport