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General NPI Number Information
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NPI Number | 1952811820
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Entity Type | Organization
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Legal Business Name | PEND OREILLE COUNTY FIRE PROTECTION DISTRICT 4
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 11 DALKENA ST
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City | NEWPORT
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State | WA
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Zip | 99156-9768
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Country | US
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Telephone | 509-447-2476
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Fax | 509-447-5530
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Provider Business Mailing Address
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Address Line | 11 DALKENA ST
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City | NEWPORT
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State | WA
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Zip | 99156-9768
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Country | US
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Telephone | 509-447-2476
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Fax | 509-447-5530
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Authorized Official
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Title or Position | CHIEF
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Name | MR. NICHOLAS KNAACK
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Credential |
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Telephone | 509-447-2476
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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 | 26D03
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License Number State | WY
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