Provider Demographics
NPI:1194790782
Name:PINEWOOD FIRE DISTRICT
Entity type:Organization
Organization Name:PINEWOOD FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-286-9885
Mailing Address - Street 1:PO BOX 18638
Mailing Address - Street 2:
Mailing Address - City:MUNDS PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:86017-8638
Mailing Address - Country:US
Mailing Address - Phone:928-286-9885
Mailing Address - Fax:928-286-2595
Practice Address - Street 1:475 EAST PINEWOOD BOULEVARD
Practice Address - Street 2:
Practice Address - City:MUNDS PARK
Practice Address - State:AZ
Practice Address - Zip Code:86017-8638
Practice Address - Country:US
Practice Address - Phone:928-286-9885
Practice Address - Fax:928-286-2595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0151380OtherBCBS
AZ113879001Medicaid
AZZRGAABOtherMEDICARE ID-PIN
AZ87265OtherBENESIGHT
AZ1Z6659OtherHEALTHNET
AZ590008390OtherMEDICARE PALMETTO R/R
AZ1Z6659OtherHEALTHNET
AZZRGAABMedicare ID - Type Unspecified