Provider Demographics
NPI:1801910666
Name:CADDO PARISH FIRE DISTRICT #3
Entity type:Organization
Organization Name:CADDO PARISH FIRE DISTRICT #3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NIEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-357-9977
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:LA
Mailing Address - Zip Code:71033-0026
Mailing Address - Country:US
Mailing Address - Phone:888-357-9977
Mailing Address - Fax:888-747-9963
Practice Address - Street 1:9081 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:LA
Practice Address - Zip Code:71033
Practice Address - Country:US
Practice Address - Phone:318-938-5290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA91100103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAC1153OtherBCBS
LA47084OtherMEDICARE
LA1955922Medicaid