Provider Demographics
NPI:1396721395
Name:CITY OF FEDERAL HEIGHTS
Entity type:Organization
Organization Name:CITY OF FEDERAL HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-412-3560
Mailing Address - Street 1:PO BOX 5223
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5223
Mailing Address - Country:US
Mailing Address - Phone:303-428-3526
Mailing Address - Fax:303-428-0494
Practice Address - Street 1:2400 W 90TH AVE
Practice Address - Street 2:
Practice Address - City:FEDERAL HEIGHTS
Practice Address - State:CO
Practice Address - Zip Code:80260-5102
Practice Address - Country:US
Practice Address - Phone:303-428-3526
Practice Address - Fax:303-428-0494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COEXEMPT3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06000665Medicaid
COC60953Medicare PIN