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General NPI Number Information
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NPI Number | 1023332392
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Entity Type | Organization
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Legal Business Name | NEWPORT EMERGENCY SERVICES INC
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Dates
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Enumeration Date | 03/16/2010
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 203 E 4TH ST N
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City | OLDTOWN
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State | ID
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Zip | 83822-9546
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Country | US
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Telephone | 509-447-4108
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Fax | 208-437-0886
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Provider Business Mailing Address
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Address Line | 203 E 4TH ST N
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City | OLDTOWN
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State | ID
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Zip | 83822-9546
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Country | US
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Telephone | 509-447-4108
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Fax | 208-437-0886
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Authorized Official
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Title or Position | CEO
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Name | MR. STEVEN C GROOM
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Credential |
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Telephone | 509-447-4108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 26X02
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License Number State | WA
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