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General NPI Number Information
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NPI Number | 1912911868
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Entity Type | Organization
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Legal Business Name | IDANHA DETROIT RURAL FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 160 DETROIT AVE N
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City | DETROIT
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State | OR
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Zip | 97342
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Country | US
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Telephone | 503-854-3494
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Fax | 503-854-3238
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Provider Business Mailing Address
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Address Line | PO BOX 3510
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City | SILVERDALE
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State | WA
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Zip | 98383-3510
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Country | US
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Telephone | 360-394-7020
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Fax | 360-394-7099
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | KELLY GALBRAITH
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Credential |
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Telephone | 503-854-3494
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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 | 2401
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License Number State | OR
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