Provider Demographics
NPI:1851403588
Name:TOWN OF PALISADE
Entity Type:Organization
Organization Name:TOWN OF PALISADE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:970-464-5602
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:PALISADE
Mailing Address - State:CO
Mailing Address - Zip Code:81526-0128
Mailing Address - Country:US
Mailing Address - Phone:970-464-5602
Mailing Address - Fax:
Practice Address - Street 1:175 E 3RD
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526
Practice Address - Country:US
Practice Address - Phone:970-464-5602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06633937Medicaid
COC63393Medicare PIN