Healthcare Provider Details

I. General information

NPI: 1932283785
Provider Name (Legal Business Name): DOUGLAS COUNTY FIRE DISTRICT NO. 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BUCKHORN ROAD
ROSEBURG OR
97471
US

IV. Provider business mailing address

1400 BUCKHORN ROAD
ROSEBURG OR
97471
US

V. Phone/Fax

Practice location:
  • Phone: 541-673-5503
  • Fax: 541-673-5505
Mailing address:
  • Phone: 541-673-5503
  • Fax: 541-673-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN R POWELL
Title or Position: OPS EXECUTIVE ASSIST./AUTH. OFFICIA
Credential:
Phone: 541-673-5503