Agate Fire Protection District
Organization Active NPI Land Ambulance · Agate, CO
NPI 1629346358 · NPPES record last updated Apr 8, 2013
Key facts
- NPI
- 1629346358
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- AGATE FIRE PROTECTION DISTRICT
- Practice address
- 40160 County Road 153
Agate, CO 80101 - Phone
- (719) 764-2771
- NPI assigned
- Dec 8, 2011
- Organization subpart
- No
Authorized official
- Name
- Mr. Larry G Rector
- Title
- Chief
- Phone
- (719) 740-1989
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D2276187 | Agate Fire Protection District | Certificate of waiver | Feb 2, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120911000321 | CO | Part B Supplier - Ambulance Service Supplier | 0648428912 | Practice locations: Agate, CO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
40160 County Road 153
Agate, CO 80101
Mailing address
40160 County Road 153
Agate, CO 80101
Phone (719) 764-2771
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 88371581 | Medicaid | CO |
Other providers in Agate, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.