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General NPI Number Information
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NPI Number | 1588616445
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Entity Type | Organization
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Legal Business Name | ST PAUL RURAL FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 4233 CHURCH STREET
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City | ST PAUL
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State | OR
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Zip | 97137-0001
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Country | US
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Telephone | 503-633-4602
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Fax | 503-633-4601
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Provider Business Mailing Address
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Address Line | PO BOX 1
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City | SAINT PAUL
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State | OR
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Zip | 97137-0001
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Country | US
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Telephone | 503-633-4602
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Fax | 503-633-4601
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Authorized Official
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Title or Position | CHAIR
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Name | MR. JERRY MULLEN
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Credential |
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Telephone | 503-932-5135
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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 | 2408-06
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License Number State | OR
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