Provider Demographics
NPI:1770687154
Name:TOWN OF YUMA
Entity Type:Organization
Organization Name:TOWN OF YUMA
Other - Org Name:CITY OF YUMA AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT INTERMEDIATE RN
Authorized Official - Phone:970-848-0372
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:CO
Mailing Address - Zip Code:80759
Mailing Address - Country:US
Mailing Address - Phone:970-848-0372
Mailing Address - Fax:970-848-0583
Practice Address - Street 1:302 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:CO
Practice Address - Zip Code:80759
Practice Address - Country:US
Practice Address - Phone:970-848-0372
Practice Address - Fax:970-848-0583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06609630Medicaid
CO06609630Medicaid