Provider Demographics
NPI:1902925928
Name:NUCLA-NATURITA FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:NUCLA-NATURITA FIRE PROTECTION DISTRICT
Other - Org Name:NUCLA-NATURITA AMBULANCE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLASPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-417-6440
Mailing Address - Street 1:PO BOX 740
Mailing Address - Street 2:
Mailing Address - City:NUCLA
Mailing Address - State:CO
Mailing Address - Zip Code:81424-0740
Mailing Address - Country:US
Mailing Address - Phone:970-864-7377
Mailing Address - Fax:970-864-7371
Practice Address - Street 1:555 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NUCLA
Practice Address - State:CO
Practice Address - Zip Code:81424
Practice Address - Country:US
Practice Address - Phone:970-864-7377
Practice Address - Fax:970-864-7371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06633630Medicaid