1598717514 NPI number — CITY OF HOOD RIVER

Table of content: (NPI 1598717514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598717514 NPI number — CITY OF HOOD RIVER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF HOOD RIVER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOOD RIVER AMBULANCE SERVICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598717514
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
211 2ND STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOOD RIVER
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-386-9458
Provider Business Mailing Address Fax Number:
541-387-4590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1785 MEYER PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOOD RIVER
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97031-1316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-386-9458
Provider Business Practice Location Address Fax Number:
541-387-4590
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHEELER
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CITY MANAGER
Authorized Official Telephone Number:
541-387-5252

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1403-06 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 006161000 . This is a "BLUE CROSS/BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 078790 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590133448 . This is a "PALMETTO GBA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9155003 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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