Provider Demographics
NPI:1871554436
Name:WESTERN EAGLE COUNTY AMBULANCE DISTRICT
Entity type:Organization
Organization Name:WESTERN EAGLE COUNTY AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-328-1130
Mailing Address - Street 1:PO BOX 1809
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631-1809
Mailing Address - Country:US
Mailing Address - Phone:970-328-1130
Mailing Address - Fax:970-328-1132
Practice Address - Street 1:0360 EBY CREEK ROAD
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631
Practice Address - Country:US
Practice Address - Phone:970-328-1130
Practice Address - Fax:970-328-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06000095Medicaid
COC61853Medicare ID - Type Unspecified