Provider Demographics
NPI:1063734903
Name:TOWN OF BERNALILLO FIRE DEPARTMENT
Entity type:Organization
Organization Name:TOWN OF BERNALILLO FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-771-7135
Mailing Address - Street 1:829 CAMINO DEL PUEBLO
Mailing Address - Street 2:
Mailing Address - City:BERNALILLO
Mailing Address - State:NM
Mailing Address - Zip Code:87004-0638
Mailing Address - Country:US
Mailing Address - Phone:505-771-7135
Mailing Address - Fax:505-771-7102
Practice Address - Street 1:829 CAMINO DEL PUEBLO
Practice Address - Street 2:NOTE
Practice Address - City:BERNALILLO
Practice Address - State:NM
Practice Address - Zip Code:87004-0638
Practice Address - Country:US
Practice Address - Phone:505-771-7135
Practice Address - Fax:505-771-7102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies