Provider Demographics
NPI:1730281775
Name:LOS PINOS FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:LOS PINOS FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILDRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-903-2185
Mailing Address - Street 1:PO BOX 319
Mailing Address - Street 2:
Mailing Address - City:IGNACIO
Mailing Address - State:CO
Mailing Address - Zip Code:81137-0319
Mailing Address - Country:US
Mailing Address - Phone:970-563-9501
Mailing Address - Fax:970-563-9369
Practice Address - Street 1:275 BROWNING AVENUE
Practice Address - Street 2:
Practice Address - City:IGNACIO
Practice Address - State:CO
Practice Address - Zip Code:81137
Practice Address - Country:US
Practice Address - Phone:970-563-9501
Practice Address - Fax:970-563-9369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONO #3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37805029Medicaid
CO37805029Medicaid
COC800977Medicare PIN