Provider Demographics
NPI:1457531568
Name:SOUTHERN YAVAPAI FIRE DEPARTMENT
Entity Type:Organization
Organization Name:SOUTHERN YAVAPAI FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LOHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-442-3359
Mailing Address - Street 1:9000 MAGBY DRIVE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:AZ
Mailing Address - Zip Code:86332-4022
Mailing Address - Country:US
Mailing Address - Phone:928-442-9720
Mailing Address - Fax:
Practice Address - Street 1:9000 MAGBY DRIVE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:AZ
Practice Address - Zip Code:86332-4022
Practice Address - Country:US
Practice Address - Phone:928-442-9720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty