Provider Demographics
NPI:1871648907
Name:CITY OF KINGSBURG
Entity Type:Organization
Organization Name:CITY OF KINGSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-897-6531
Mailing Address - Street 1:1460 MARION ST
Mailing Address - Street 2:
Mailing Address - City:KINGSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:93631-1927
Mailing Address - Country:US
Mailing Address - Phone:559-897-6531
Mailing Address - Fax:559-897-6531
Practice Address - Street 1:1460 MARION ST
Practice Address - Street 2:
Practice Address - City:KINGSBURG
Practice Address - State:CA
Practice Address - Zip Code:93631-1927
Practice Address - Country:US
Practice Address - Phone:559-897-6537
Practice Address - Fax:559-897-0366
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF KINGSBURG
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-25
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31296ZMedicaid
CA590423048OtherRAILROAD MEDICARE
CA590423048OtherRAILROAD MEDICARE