Provider Demographics
NPI:1548326549
Name:DONNER SUMMIT FIRE DEPARTMENT
Entity type:Organization
Organization Name:DONNER SUMMIT FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN CLERK
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-426-3000
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-9610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:53823 SHERITT LANE
Practice Address - Street 2:
Practice Address - City:SODA SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95728
Practice Address - Country:US
Practice Address - Phone:530-426-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTE01008FMedicaid
CAMTE01008FMedicaid