Provider Demographics
NPI:1326010638
Name:BAKER HILL FIRE & RESCUE LLC
Entity type:Organization
Organization Name:BAKER HILL FIRE & RESCUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF/EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:334-316-1065
Mailing Address - Street 1:1053 COUNTY RD 79S LOT 53
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-8814
Mailing Address - Country:US
Mailing Address - Phone:334-316-1065
Mailing Address - Fax:334-687-3300
Practice Address - Street 1:1956 AL HWY 131
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-3925
Practice Address - Country:US
Practice Address - Phone:334-316-1065
Practice Address - Fax:334-687-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL129341600000X
AL1076341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000054395Medicaid
AL200003105Medicaid
AL510-54395OtherBC-AL
AL129OtherSTATE LICENSE