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General NPI Number Information
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NPI Number | 1073603528
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Entity Type | Organization
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Legal Business Name | CRESCENT RURAL FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 10/10/2018
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Provider Practice Location Address
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Address Line | 150 MOUNTAIN VIEW DR
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City | GILCHRIST
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State | OR
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Zip | 97737-3244
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Country | US
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Telephone | 541-433-2466
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Fax | 541-433-2600
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Provider Business Mailing Address
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Address Line | PO BOX 811
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City | GILCHRIST
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State | OR
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Zip | 97737-0811
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Country | US
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Telephone | 541-433-2466
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Fax | 541-433-2600
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Authorized Official
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Title or Position | PRESIDENT, BOARD OF DIRECTORS
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Name | ROBERT LEWIS PETERSEN
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Credential |
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Telephone | 541-433-2466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1830
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License Number State | OR
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