Provider Demographics
NPI:1891152567
Name:WHITE MOUNTAIN APACHE TRIBE FIRE AND RESCUE
Entity Type:Organization
Organization Name:WHITE MOUNTAIN APACHE TRIBE FIRE AND RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:A/R MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGENBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-368-6799
Mailing Address - Street 1:612 S. CHIEF AVE
Mailing Address - Street 2:
Mailing Address - City:WHITERIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85941
Mailing Address - Country:US
Mailing Address - Phone:928-368-6799
Mailing Address - Fax:928-368-8776
Practice Address - Street 1:612 S. CHIEF AVE
Practice Address - Street 2:
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941
Practice Address - Country:US
Practice Address - Phone:928-368-6799
Practice Address - Fax:928-368-8776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport