Provider Demographics
NPI:1144250531
Name:PARK CITY FIRE SERVICE DISTRICT
Entity type:Organization
Organization Name:PARK CITY FIRE SERVICE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BATTALION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-940-2503
Mailing Address - Street 1:PO BOX 27768
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0768
Mailing Address - Country:US
Mailing Address - Phone:801-975-4319
Mailing Address - Fax:801-352-9502
Practice Address - Street 1:736 BITNER RD
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5432
Practice Address - Country:US
Practice Address - Phone:435-940-2500
Practice Address - Fax:435-940-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1144250531Medicaid
UT590011561OtherRAILROAD MEDICARE
X02215Medicare UPIN
UT000009082Medicare PIN