Arivaca Fire District
Organization Active NPI Land Ambulance · Arivaca, AZ
NPI 1972879716 · NPPES record last updated Nov 3, 2025
Key facts
- NPI
- 1972879716
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- G066GD (AZ)
- Legal business name
- ARIVACA FIRE DISTRICT
- Practice address
- 16091 West Universal Ranch Road
Arivaca, AZ 85601-0416 - Phone
- (520) 398-2003
- Fax
- (520) 398-2607
- NPI assigned
- Mar 27, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Scott Van Boerum
- Title
- Fire Chief
- Phone
- (520) 398-2003
Corporate family (same tax ID) 1
Practitioners 1
-
Evan Laughlin, EMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140703000993 | AZ | Part B Supplier - Ambulance Service Supplier | 0941425045 | Practice locations: Arivaca, AZ |
National Provider Directory
- Tax ID family
- Arivaca Fire District
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | G066GD | AZ | Yes |
Addresses
Primary practice location
16091 West Universal Ranch Road
Arivaca, AZ 85601-0416
Mailing address
PO Box 416
Arivaca, AZ 85601-0416
Phone (520) 398-2003
Other providers in Arivaca, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2025. 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.