1801941315 NPI number — CITY OF CAMAS

Table of content: (NPI 1801941315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801941315 NPI number — CITY OF CAMAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF CAMAS
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:
CAMAS FIRE DEPARTMENT
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:
1801941315
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
616 NE 4TH AVE
Provider Second Line Business Mailing Address:
STE 1
Provider Business Mailing Address City Name:
CAMAS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98607-2108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-834-2262
Provider Business Mailing Address Fax Number:
360-834-8854

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
616 NE 4TH AVE
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
CAMAS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98607-2108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-834-2262
Provider Business Practice Location Address Fax Number:
360-834-8854
Provider Enumeration Date:
01/24/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SWINHART
Authorized Official First Name:
NICK
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
360-834-2262

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  06M02 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0026983 . This is a "LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 822443000 . This is a "REGENCE BLUE CROSS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9137902 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".