=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033112594
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF SALEM
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2005
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2742 25TH ST SE
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97302-1108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-588-6271
-----------------------------------------------------
Fax | 503-588-6202
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2790 25TH ST SE
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97302-1108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-588-6271
-----------------------------------------------------
Fax | 503-588-6202
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSISTANT CHIEF OF BUSINESS OPERATI
-----------------------------------------------------
Name | BRIAN L CARRARA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 503-932-5785
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 241105
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------