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General NPI Number Information
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NPI Number | 1245324169
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Entity Type | Organization
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Legal Business Name | BASIN AMBULANCE SERVICE DISTRICT
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 24971 HWY 39
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City | MERRILL
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State | OR
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Zip | 97633
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Country | US
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Telephone | 541-798-5175
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Fax | 541-798-5175
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Provider Business Mailing Address
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Address Line | PO BOX 284
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City | MALIN
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State | OR
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Zip | 97632-0284
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Country | US
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Telephone | 541-798-5175
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Fax | 541-798-5175
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | DAN ORR
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Credential |
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Telephone | 541-798-5175
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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 | 1829
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License Number State | OR
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