Provider Demographics
NPI:1669486593
Name:COLORADO CITY FIRE DISTRICT
Entity Type:Organization
Organization Name:COLORADO CITY FIRE DISTRICT
Other - Org Name:COLORADO CITY FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-875-2400
Mailing Address - Street 1:40 SOUTH PIONEER STREET
Mailing Address - Street 2:PO BOX 1588
Mailing Address - City:COLORADO CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86021-1588
Mailing Address - Country:US
Mailing Address - Phone:928-875-2400
Mailing Address - Fax:928-875-2056
Practice Address - Street 1:40 SOUTH PIONEER ST.
Practice Address - Street 2:
Practice Address - City:COLORADO CITY
Practice Address - State:AZ
Practice Address - Zip Code:86021-1588
Practice Address - Country:US
Practice Address - Phone:928-875-2400
Practice Address - Fax:928-875-2056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ223416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ071853Medicaid
UT=========001Medicaid