Fort Mojave Mesa Fire Department
Organization Active NPI Land Ambulance · Fort Mohave, AZ
NPI 1942393517 · NPPES record last updated Aug 14, 2014
Key facts
- NPI
- 1942393517
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 82 (AZ)
- Legal business name
- FORT MOJAVE MESA FIRE DEPARTMENT
- Practice address
- 2230 Joy LN
Fort Mohave, AZ 86426-6625 - Phone
- (928) 768-9181
- Fax
- (928) 768-8434
- NPI assigned
- Oct 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Steve A West
- Title
- Battalion Chief
- Phone
- (928) 768-9181
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100319000520 | AZ | Part B Supplier - Ambulance Service Supplier | 2860527553 | Practice locations: Fort Mohave, AZ |
National Provider Directory
Locations
2230 E Joy Ln
Fort Mohave, AZ 86426
Phone (520) 768-9181
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 82 | AZ | Yes |
Addresses
Primary practice location
2230 Joy LN
Fort Mohave, AZ 86426-6625
Mailing address
2230 Joy LN
P.O. Box 8488
Fort Mohave, AZ 86426-6625
Phone (928) 768-9181
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071407 | Medicaid | AZ | |
| 8886341300 | Other | AZ | KAISER FOUNDATION |
| AZ0151150 | Other | AZ | BC/BS/AZ |
| XMT002750 | Medicaid | AZ | |
| 3288114 | Medicaid | AZ | |
| 003288081 | Medicaid | AZ | |
| 014822-0001 | Other | AZ | PACIFICARE |
| AZ626073 | Other | AZ | OXFORD |
| C09900004351 | Other | AZ | SIERRA HEALTH |
Other providers in Fort Mohave, AZ
- Emergency Physicians Medical Group Inc
- Nathan John Ethridge
- Fort Mohave Dental Care PLLC
- Fort Mohave Emergency Medical Associates Inc
- Fort Mohave Physical Therapy Inc
- Founders Healthcare, LLC
- Lisa Franklin
- Stephanie Marie Garney
- Jim Gilbert
- Rebecca Lynn Gleason
All providers in Fort Mohave, AZ · Land Ambulance in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2014. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.