SOUTH PARK AMBULANCE DISTRICT NPI 1811091051

NPI Information

SOUTH PARK AMBULANCE DISTRICT is a land transport ambulance in Fairplay, CO. SOUTH PARK AMBULANCE DISTRICT NPI is 1811091051. The provider is registered as an organization entity type.

The provider's business location address is:

911 CASTELLO AVENUE
FAIRPLAY, CO
ZIP 80440
Phone: (719) 836-2055

The provider's authorized official is Lissa Mattson .
The authorized official title is Chief Administrative Officer and has the following contact phone number (719) 836-2055.

The CLIA number assigned to this NPI record is 06D0698408 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/8/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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