Provider Demographics
NPI:1871520817
Name:KIM AREA VOLUNTEER FIRE DEPARTMENT AND AMBULANCE SERVICE
Entity type:Organization
Organization Name:KIM AREA VOLUNTEER FIRE DEPARTMENT AND AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:LON
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-643-5265
Mailing Address - Street 1:115 LAS ANIMAS AVE
Mailing Address - Street 2:P.O. BOX 137
Mailing Address - City:KIM
Mailing Address - State:CO
Mailing Address - Zip Code:81049-0137
Mailing Address - Country:US
Mailing Address - Phone:719-643-5265
Mailing Address - Fax:719-643-5265
Practice Address - Street 1:115 LAS ANIMAS AVE
Practice Address - Street 2:
Practice Address - City:KIM
Practice Address - State:CO
Practice Address - Zip Code:81049-0137
Practice Address - Country:US
Practice Address - Phone:719-643-5265
Practice Address - Fax:719-643-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLA COUNTY 2005-01146L00000X, 146M00000X, 146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Not Answered146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
Not Answered146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty