Provider Demographics
NPI:1659945533
Name:SOUTHERN PARK COUNTY FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:SOUTHERN PARK COUNTY FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:G
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-689-9479
Mailing Address - Street 1:PO BOX 641880
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7880
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:
Practice Address - Street 1:8340 CR102
Practice Address - Street 2:
Practice Address - City:GUFFREY
Practice Address - State:CO
Practice Address - Zip Code:80820-9606
Practice Address - Country:US
Practice Address - Phone:719-689-9479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport