Organization
LAKESIDE VOLUNTEER FIRE DEPARTMENT
Active
Other names
Lakeside Fire District
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY L VAN SCOTER (FIRE CHIEF)
(928) 368-6112
Entity
Organization
Contact information
Practice address
2922 W WHITE MOUNTAIN BLVD, LAKESIDE, AZ 85929-0000
(928) 368-6112
(928) 368-6543
Mailing address
PO BOX 1109, LAKESIDE, AZ 85929-1109
(928) 368-6112
(928) 368-5643
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
AZCON111
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152843
—
AZ
01
—
AZ0151440
BLUE CROSS
AZ
Enumeration date
02/08/2006
Last updated
09/11/2008
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