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General NPI Number Information
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NPI Number | 1720511710
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Entity Type | Organization
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Legal Business Name | EAST UMATILLA COUNTY AMBULANCE AREA HEALTH DISTRICT
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Dates
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Enumeration Date | 04/06/2017
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 431 E MAIN STREET
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City | ATHENA
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State | OR
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Zip | 97813-0640
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Country | US
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Telephone | 541-566-3813
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Fax | 877-469-6944
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | ATHENA
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State | OR
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Zip | 97813-0640
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Country | US
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Telephone | 541-566-3813
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Fax | 877-469-6944
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JEFFERY TODD ROST
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Credential | RN
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Telephone | 541-566-3813
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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 | 3004
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License Number State | OR
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