1467509026 NPI number — CITY OF POWERS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467509026 NPI number — CITY OF POWERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF POWERS
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:
Provider Other Organization Name Type Code:
6
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:
1467509026
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POWERS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97466-0250
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-439-2031
Provider Business Mailing Address Fax Number:
541-439-2031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 FIR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POWERS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97466-0250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-439-2031
Provider Business Practice Location Address Fax Number:
541-439-2031
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DUDLEY
Authorized Official First Name:
LAURAL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
FIRE CHIEF/AMBULANCE DIRECTOR
Authorized Official Telephone Number:
541-439-2031

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0603 , 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: 0603 . This is a "AMBULANCE STATE NUMBER" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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