Organization
TUBAC FIRE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA HOLBROOK (CHIEF FINANCIAL OFFICER)
(520) 398-2255
Entity
Organization
Contact information
Practice address
2227 E. FRONTAGE RD., TUBAC, AZ 85646
(520) 398-2255
(520) 398-2933
Mailing address
PO BOX 2881, TUBAC, AZ 85646-2881
(520) 398-2255
(520) 398-2933
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
CON #6
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348153
—
AZ
01
—
590014166
ADMINISTRATIVE ENTERPRISE
AZ
01
—
AY6472
ACH/HEALTH NET
AZ
01
—
AZ0000D100314
PR1011 TRAIL BLAZER HE
AZ
01
—
AZ0152290
BCBS OF ARIZONA
AZ
Enumeration date
04/20/2006
Last updated
05/02/2016
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