Provider Demographics
NPI:1548364789
Name:MCCALL FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:MCCALL FIRE PROTECTION DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-634-7070
Mailing Address - Street 1:PO BOX 3510
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-3510
Mailing Address - Country:US
Mailing Address - Phone:360-394-7010
Mailing Address - Fax:360-394-7099
Practice Address - Street 1:201 DEINHARD LN
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638-4604
Practice Address - Country:US
Practice Address - Phone:208-634-7070
Practice Address - Fax:208-634-5360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID#74273416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010014763OtherBLUE SHIELD
ID0026481Medicaid
ID1540888OtherUNITED MINE WORKERS
IDE0880OtherBLUE CROSS
ID590011274OtherRAILROAD MEDICARE
ID0026481Medicaid