Active NPI
Forest Lakes Fire District
- Ambulance
- Forest Lakes, AZ
National Provider Identifier
1770565962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- FOREST LAKES FIRE DISTRICT
- Practice address
- 4 Merzville Rd
Forest Lakes, AZ 85931-1808 - Phone
- (928) 535-4644
- Fax
- (928) 535-5448
- NPI assigned
- Nov 15, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charles E McGee
- Title
- Chief
- Phone
- (928) 535-4644
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary |
Addresses
Primary practice location
4 Merzville Rd
Forest Lakes, AZ 85931-1808
Mailing address
PO Box 1808
Forest Lakes, AZ 85931-1808
Phone (928) 535-4644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16568001 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051223000212 | AZ | Part B Supplier - Ambulance Service Supplier | 4284656893 | Practice locations: Forest Lakes, AZ |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1770565962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1808",
"city": "FOREST LAKES",
"state": "AZ",
"postal_code": "859311808",
"telephone_number": "928-535-4644",
"fax_number": "928-535-5448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 MERZVILLE RD",
"city": "FOREST LAKES",
"state": "AZ",
"postal_code": "859311808",
"telephone_number": "928-535-4644",
"fax_number": "928-535-5448"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOREST LAKES FIRE DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MCGEE",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "CHIEF",
"authorized_official_telephone_number": "928-535-4644"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16568001",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.