1033535075 NPI number — TRI-COUNTY FIRE PROTECTION DISTRICT

Table of content: ERROL ALEXANDER WILSON DDS (NPI 1649288978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033535075 NPI number — TRI-COUNTY FIRE PROTECTION DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRI-COUNTY FIRE PROTECTION DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033535075
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 97
Provider Second Line Business Mailing Address:
590 NORTH RUSH ROAD
Provider Business Mailing Address City Name:
RUSH
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80833-0097
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-478-2345
Provider Business Mailing Address Fax Number:
719-478-2345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
590 NORTH RUSH ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUSH
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80833-0097
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-478-2345
Provider Business Practice Location Address Fax Number:
719-478-2345
Provider Enumeration Date:
03/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
COWDEN
Authorized Official First Name:
TROY
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
EMS CAPTAIN
Authorized Official Telephone Number:
719-478-2345

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  2013-010ELPASOCOUNTY , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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