Healthcare Provider Details

I. General information

NPI: 1467509026
Provider Name (Legal Business Name): CITY OF POWERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 FIR ST
POWERS OR
97466-0250
US

IV. Provider business mailing address

PO BOX 250
POWERS OR
97466-0250
US

V. Phone/Fax

Practice location:
  • Phone: 541-439-2031
  • Fax: 541-439-2031
Mailing address:
  • Phone: 541-439-2031
  • Fax: 541-439-2031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0603
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier0603
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerAMBULANCE STATE NUMBER

VIII. Authorized Official

Name: MRS. LAURAL M DUDLEY
Title or Position: FIRE CHIEF/AMBULANCE DIRECTOR
Credential:
Phone: 541-439-2031