Provider Demographics
NPI:1770565962
Name:FOREST LAKES FIRE DISTRICT
Entity type:Organization
Organization Name:FOREST LAKES FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-535-4644
Mailing Address - Street 1:PO BOX 1808
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85931-1808
Mailing Address - Country:US
Mailing Address - Phone:928-535-4644
Mailing Address - Fax:928-535-5448
Practice Address - Street 1:4 MERZVILLE RD
Practice Address - Street 2:
Practice Address - City:FOREST LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85931-1808
Practice Address - Country:US
Practice Address - Phone:928-535-4644
Practice Address - Fax:928-535-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ16568001Medicaid
AZRJBBBMedicare ID - Type Unspecified