Organization
MODESTO FIRE DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM TIETJEN (DIVISION CHIEF)
(209) 342-4545
Entity
Organization
Contact information
Practice address
409 12TH ST, MODESTO, CA 95354-2401
(209) 572-9590
(209) 544-1652
Mailing address
409 12TH ST, MODESTO, CA 95354-2401
(209) 572-9590
(209) 544-1652
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
333300000X
Emergency Response System Companies
—
—
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
—
—
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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