Provider Demographics
NPI:1881132843
Name:ANDERSON VALLEY COMMUNITY SERVICE DISTRICT
Entity type:Organization
Organization Name:ANDERSON VALLEY COMMUNITY SERVICE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-895-2020
Mailing Address - Street 1:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95415-0398
Mailing Address - Country:US
Mailing Address - Phone:707-895-2020
Mailing Address - Fax:
Practice Address - Street 1:14281 HWY 128
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95415
Practice Address - Country:US
Practice Address - Phone:707-895-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance