Provider Demographics
NPI:1710030291
Name:ST TAMMANY PARISH FIRE DIST 3
Entity Type:Organization
Organization Name:ST TAMMANY PARISH FIRE DIST 3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:III
Authorized Official - Credentials:CHIEF OF OPERATIONS
Authorized Official - Phone:985-882-5977
Mailing Address - Street 1:PO BOX 849
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445
Mailing Address - Country:US
Mailing Address - Phone:985-882-5977
Mailing Address - Fax:985-882-6664
Practice Address - Street 1:27690 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445
Practice Address - Country:US
Practice Address - Phone:985-882-3902
Practice Address - Fax:985-882-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9110058146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1177962Medicaid
1900G8471ZOtherBCBS
LA5CP74Medicare UPIN
LA1177962Medicaid