Provider Demographics
NPI:1881858660
Name:BLUFFDALE CITY CORP
Entity Type:Organization
Organization Name:BLUFFDALE CITY CORP
Other - Org Name:BLUFFDALE FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:V
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:801-295-9886
Mailing Address - Street 1:14350 SOUTH 2200 WEST
Mailing Address - Street 2:
Mailing Address - City:BLUFFDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84065
Mailing Address - Country:US
Mailing Address - Phone:801-254-2200
Mailing Address - Fax:801-253-3270
Practice Address - Street 1:14350 S 2200 W
Practice Address - Street 2:
Practice Address - City:BLUFFDALE
Practice Address - State:UT
Practice Address - Zip Code:84065-5328
Practice Address - Country:US
Practice Address - Phone:801-254-2200
Practice Address - Fax:801-253-3270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUFFDALE CITY CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-11
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1869L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport