1578782991 NPI number — CITY OF OCEAN SHORES

Table of content: (NPI 1578782991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578782991 NPI number — CITY OF OCEAN SHORES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF OCEAN SHORES
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:
1578782991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 909
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCEAN SHORES
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98569-0909
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-200-1191
Provider Business Mailing Address Fax Number:
336-740-9793

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 ANCHOR AVE NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCEAN SHORES
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98569-9700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-289-3611
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RITTER
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
360-289-3611

Provider Taxonomy Codes

  • Taxonomy code: 261QE0002X , with the licence number:  14M08 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 590002368 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9168808 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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