Provider Demographics
NPI:1144356148
Name:MIDWAY FIRE DISTRICT
Entity type:Organization
Organization Name:MIDWAY FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURBANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-932-4771
Mailing Address - Street 1:1322 COLLEGE PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-2780
Mailing Address - Country:US
Mailing Address - Phone:850-932-4771
Mailing Address - Fax:850-934-1333
Practice Address - Street 1:1322 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-2780
Practice Address - Country:US
Practice Address - Phone:850-932-4771
Practice Address - Fax:850-934-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL029255341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA0760OtherBLUE CROSS BLUE SHIELD