Black Canyon Fire District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

121 Issued in AZ

Legal business name

BLACK CANYON FIRE DISTRICT

Doing business as

Black Canyon Fire Department

Practice address

35050 S Old Black Canyon Hwy
Black Canyon City, AZ 85324-9771

Phone

(623) 374-5512

Fax

(623) 374-5513

NPI assigned

Sep 7, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Mark Nichols

Title

Fire Chief

Phone

(623) 374-5512

Specialties & licenses 1

Addresses

Other names 1

• Black Canyon Fire Department Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1194719997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "BLACK CANYON CITY",
            "state": "AZ",
            "postal_code": "853240967",
            "telephone_number": "623-374-5512",
            "fax_number": "623-374-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35050 S OLD BLACK CANYON HWY",
            "city": "BLACK CANYON CITY",
            "state": "AZ",
            "postal_code": "853249771",
            "telephone_number": "623-374-5512",
            "fax_number": "623-374-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK CANYON FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "623-374-5512"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AZ",
            "license": "121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Black Canyon Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Black Canyon City Dentistry LLC
• Black Canyon Community Health Center, Inc.
• Black Canyon Community Health Center, Inc.
• Black Canyon Physical Therapy, PLLC
• Marci Brown-Gilpin, LCSW
• Canon Elementary School District
• Canyon Medical Clinic LLC
• Emd Medical Services LLC (Cherry Family Practice)

• Land Ambulance in Black Canyon City, AZ
• Providers in Black Canyon City, AZ by specialty
• Land Ambulance in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.