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General NPI Number Information
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NPI Number | 1811999535
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Entity Type | Organization
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Legal Business Name | SOUTH LINCOLN AMBULANCE INC.
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | 215 W 2ND ST
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City | YACHATS
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State | OR
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Zip | 97498
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Country | US
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Telephone | 541-547-3266
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Fax | 541-547-4257
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Provider Business Mailing Address
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Address Line | PO BOX 31
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City | YACHATS
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State | OR
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Zip | 97498-0031
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Country | US
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Telephone | 541-547-3766
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Fax | 541-547-4257
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Authorized Official
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Title or Position | AMBULANCE CHIEF
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Name | MS. FRANCES M PETRICK
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Credential |
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Telephone | 541-547-3266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 2112-06
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License Number State | OR
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