Provider Demographics
NPI:1750455200
Name:CITY OF BERKELEY FIRE DEPT
Entity Type:Organization
Organization Name:CITY OF BERKELEY FIRE DEPT
Other - Org Name:CITY OF BERKELEY
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:IMRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-981-5502
Mailing Address - Street 1:PO BOX 11914
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94712-2914
Mailing Address - Country:US
Mailing Address - Phone:510-981-5538
Mailing Address - Fax:
Practice Address - Street 1:2100 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1109
Practice Address - Country:US
Practice Address - Phone:510-981-5538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ81739ZMedicaid
CA756590582Medicare PIN
ZZZ81739ZMedicare PIN