Healthcare Provider Details

I. General information

NPI: 1558668889
Provider Name (Legal Business Name): ROGUE RIVER RURAL FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5474 N RIVER RD
GOLD HILL OR
97525-5734
US

IV. Provider business mailing address

PO BOX 1170
ROGUE RIVER OR
97537-1170
US

V. Phone/Fax

Practice location:
  • Phone: 541-582-4411
  • Fax: 541-582-3456
Mailing address:
  • Phone: 541-582-4411
  • Fax: 541-582-3456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1550-06
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier1407878374
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerNPI FOR AMBULANCE SERVICE
# 2
Identifier036660
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name: BENNY G RAMSEY
Title or Position: FIRE CHIEF
Credential:
Phone: 541-582-4411