Provider Demographics
NPI:1457353542
Name:GRAND VALLEY FIRE PROTECTION DIST PENSION FUND
Entity Type:Organization
Organization Name:GRAND VALLEY FIRE PROTECTION DIST PENSION FUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-285-9119
Mailing Address - Street 1:124 STONE QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:PARACHUTE
Mailing Address - State:CO
Mailing Address - Zip Code:81635-9566
Mailing Address - Country:US
Mailing Address - Phone:970-285-9119
Mailing Address - Fax:970-285-9748
Practice Address - Street 1:124 STONE QUARRY RD
Practice Address - Street 2:
Practice Address - City:PARACHUTE
Practice Address - State:CO
Practice Address - Zip Code:81635-9566
Practice Address - Country:US
Practice Address - Phone:970-285-9119
Practice Address - Fax:970-285-9748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06634133Medicaid
6341-3Medicare ID - Type Unspecified