Healthcare Provider Details

I. General information

NPI: 1184377699
Provider Name (Legal Business Name): BOARDMAN FIRE RESCUE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 07/21/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 TATONE STREET
BOARDMAN OR
97818-8029
US

IV. Provider business mailing address

PO BOX 2
BOARDMAN OR
97818-0002
US

V. Phone/Fax

Practice location:
  • Phone: 541-481-3473
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MICHAEL HUGHES
Title or Position: FIRE CHIEF
Credential:
Phone: 541-481-3473