Healthcare Provider Details

I. General information

NPI: 1306279534
Provider Name (Legal Business Name): CITY OF OREGON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 08/13/2023
Certification Date: 08/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 S WYNN RD
OREGON OH
43616-3549
US

IV. Provider business mailing address

PO BOX 2122
RIVERVIEW MI
48193-1122
US

V. Phone/Fax

Practice location:
  • Phone: 419-698-7020
  • Fax: 419-698-7101
Mailing address:
  • Phone: 800-926-6985
  • Fax: 734-479-6319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: CLAYTON KENNETH OBRIEN
Title or Position: FIRE CHIEF
Credential:
Phone: 419-698-7019