Provider Demographics
NPI:1528071057
Name:ROCKY RIDGE FIRE DISTRICT
Entity type:Organization
Organization Name:ROCKY RIDGE FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:LORD
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:205-822-0532
Mailing Address - Street 1:2911 METROPOLITAN WAY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2943
Mailing Address - Country:US
Mailing Address - Phone:205-822-0532
Mailing Address - Fax:205-978-9876
Practice Address - Street 1:2911 METROPOLITAN WAY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2943
Practice Address - Country:US
Practice Address - Phone:205-822-0532
Practice Address - Fax:205-978-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL356146L00000X, 3416L0300X, 341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL200037106Medicaid
AL590011307OtherRAILROAD MEDICARE
AL590011307OtherRAILROAD MEDICARE
AL051034083Medicare UPIN