Provider Demographics
NPI:1356438378
Name:AMERICAN FORK CITY CORPORATION
Entity type:Organization
Organization Name:AMERICAN FORK CITY CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-763-3045
Mailing Address - Street 1:96 NORTH CENTER ST.
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1626
Mailing Address - Country:US
Mailing Address - Phone:801-763-3000
Mailing Address - Fax:801-763-3011
Practice Address - Street 1:96 NORTH CENTER ST.
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-1626
Practice Address - Country:US
Practice Address - Phone:801-763-3000
Practice Address - Fax:801-763-3011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X, 3416L0300X
UT2540L146L00000X
UT2501L146M00000X, 146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulanceGroup - Single Specialty
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000009116Medicare PIN
UT000009116Medicare PIN