Healthcare Provider Details

I. General information

NPI: 1891746616
Provider Name (Legal Business Name): CHEMULT RURAL FIRE PROTECTION DIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109800 HIGHWAY 97N
CHEMULT OR
97731
US

IV. Provider business mailing address

PO BOX 28
CHEMULT OR
97731
US

V. Phone/Fax

Practice location:
  • Phone: 541-365-2255
  • Fax: 541-365-2280
Mailing address:
  • Phone: 541-365-2255
  • Fax: 541-365-2260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number
License Number StateOR

VIII. Authorized Official

Name: NANCY M MORT
Title or Position: EMT COORDINATOR
Credential: EMT
Phone: 541-365-2255