Provider Demographics
NPI:1992277727
Name:RIO RICO FIRE DISTRICT
Entity type:Organization
Organization Name:RIO RICO FIRE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-281-8421
Mailing Address - Street 1:822 PENDLETON DR
Mailing Address - Street 2:
Mailing Address - City:RIO RICO
Mailing Address - State:AZ
Mailing Address - Zip Code:85648-3254
Mailing Address - Country:US
Mailing Address - Phone:520-281-8421
Mailing Address - Fax:520-281-7670
Practice Address - Street 1:822 PENDLETON DR
Practice Address - Street 2:
Practice Address - City:RIO RICO
Practice Address - State:AZ
Practice Address - Zip Code:85648-3254
Practice Address - Country:US
Practice Address - Phone:520-281-8421
Practice Address - Fax:520-281-7670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIO RICO FIRE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-18
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty
No3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ527078Medicaid