Provider Demographics
NPI:1871573006
Name:FLORENCE VOLUNTEER FIRE DEPARTMENT
Entity type:Organization
Organization Name:FLORENCE VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-784-3611
Mailing Address - Street 1:2233 E MAIN ST
Mailing Address - Street 2:BUSINESS OPTIONS MEDICAL BILLING
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3831
Mailing Address - Country:US
Mailing Address - Phone:970-249-3700
Mailing Address - Fax:970-497-8410
Practice Address - Street 1:300 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:CO
Practice Address - Zip Code:81226-1426
Practice Address - Country:US
Practice Address - Phone:719-784-3611
Practice Address - Fax:719-784-2076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590015370OtherRAILROAD WORKERS MEDICARE
618184300OtherDEPT OF LABOR FEDERAL WORKERS COMPENSATION (FECA, BLACK LUNG, ENERGY)
CO35076542Medicaid
618184300OtherDEPT OF LABOR FEDERAL WORKERS COMPENSATION (FECA, BLACK LUNG, ENERGY)