Healthcare Provider Details

I. General information

NPI: 1760416358
Provider Name (Legal Business Name): CITY OF BEND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 SW SIMPSON AVE
BEND OR
97702-3191
US

IV. Provider business mailing address

1212 SW SIMPSON AVE
BEND OR
97702-3191
US

V. Phone/Fax

Practice location:
  • Phone: 541-322-6318
  • Fax: 541-323-8510
Mailing address:
  • Phone: 541-322-6318
  • Fax: 541-323-8510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0901
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number0901
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number0901
License Number StateOR

VIII. Authorized Official

Name: SAMANTHA NELSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 541-693-2154