Provider Demographics
NPI:1154340230
Name:UPPER PINE RIVER FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:UPPER PINE RIVER FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-P
Authorized Official - Phone:970-884-9508
Mailing Address - Street 1:515 SOWER DR
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-8826
Mailing Address - Country:US
Mailing Address - Phone:970-884-9505
Mailing Address - Fax:970-884-2444
Practice Address - Street 1:515 SOWER DR
Practice Address - Street 2:
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122
Practice Address - Country:US
Practice Address - Phone:970-884-9508
Practice Address - Fax:970-884-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83384545Medicaid
COC805095Medicare PIN
C805095Medicare PIN