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General NPI Number Information
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NPI Number | 1700975638
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Entity Type | Organization
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Legal Business Name | WOODBURN AMBULANCE SERVICE, INC.
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 1040 N BOONES FERRY RD
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City | WOODBURN
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State | OR
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Zip | 97071-0584
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Country | US
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Telephone | 503-982-4699
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Fax | 503-982-4823
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Provider Business Mailing Address
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Address Line | PO BOX 584
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City | WOODBURN
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State | OR
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Zip | 97071-0584
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Country | US
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Telephone | 503-982-4699
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Fax | 503-982-4823
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MS. KATHLEEN L MORLEY
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Credential |
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Telephone | 503-982-4699
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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 | 2404
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License Number State | OR
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