Provider Demographics
NPI:1740354422
Name:COSUMNES COMMUNITY SERVICES DISTRICT
Entity type:Organization
Organization Name:COSUMNES COMMUNITY SERVICES DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS BATTALION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:SHURR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-405-7131
Mailing Address - Street 1:10573 E STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-9743
Mailing Address - Country:US
Mailing Address - Phone:916-405-7100
Mailing Address - Fax:
Practice Address - Street 1:10573 E STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-9743
Practice Address - Country:US
Practice Address - Phone:916-405-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00675FMedicaid
CA590015031Medicare PIN
CAZZZ43494ZMedicare PIN