Provider Demographics
NPI:1316499122
Name:CITY OF BENICIA - FIRE DEPARTMENT
Entity type:Organization
Organization Name:CITY OF BENICIA - FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-746-4275
Mailing Address - Street 1:250 E L ST
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-3239
Mailing Address - Country:US
Mailing Address - Phone:707-746-4275
Mailing Address - Fax:707-745-4425
Practice Address - Street 1:150 MILITARY WEST
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-3239
Practice Address - Country:US
Practice Address - Phone:707-746-4275
Practice Address - Fax:707-745-4425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty