Provider Demographics
NPI:1881680197
Name:NORTH ROUTT FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:NORTH ROUTT FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-4019
Mailing Address - Street 1:PO BOX 758
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:CO
Mailing Address - Zip Code:80428-0758
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:402-965-8594
Practice Address - Street 1:54545 COUNTY RD 129
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:CO
Practice Address - Zip Code:80428-9712
Practice Address - Country:US
Practice Address - Phone:402-572-4019
Practice Address - Fax:402-965-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5003OtherBLUE CROSS PROVIDER NUMBER
CO5003OtherBLUE CROSS PROVIDER NUMBER