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General NPI Number Information
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NPI Number | 1770652737
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Entity Type | Organization
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Legal Business Name | CITY OF COQUILLE
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 89 W 3RD ST
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City | COQUILLE
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State | OR
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Zip | 97423-1266
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Country | US
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Telephone | 541-396-2232
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Fax | 541-824-0129
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Provider Business Mailing Address
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Address Line | 89 W 3RD ST P.O. BOX 263
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City | COQUILLE
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State | OR
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Zip | 97423-1266
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Country | US
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Telephone | 541-396-2232
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Fax | 541-824-0129
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | DAVID ALLEN WADDINGTON
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Credential |
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Telephone | 541-396-2232
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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 | 0604
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License Number State | OR
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