Provider Demographics
NPI:1013913946
Name:CITY OF INDIO
Entity Type:Organization
Organization Name:CITY OF INDIO
Other - Org Name:CITY OF INDIO FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST CITY MANAGER/FINANCE DIRECTOT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-391-4029
Mailing Address - Street 1:PO BOX 2066
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92202-2066
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:46990 JACKSON ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-6042
Practice Address - Country:US
Practice Address - Phone:760-347-0756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE00228FMedicaid
CA590003314OtherRRB
CAMTE00228FMedicaid