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General NPI Number Information
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NPI Number | 1962752485
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Entity Type | Organization
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Legal Business Name | CASCADE MEDICAL TRANSPORT OF OREGON LLC
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 5385 NE 15TH DRIVE
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City | REDMOND
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State | OR
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Zip | 97756
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Country | US
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Telephone | 541-408-2855
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Fax | 541-504-4516
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Provider Business Mailing Address
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Address Line | P.O. BOX 5486
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City | BEND
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State | OR
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Zip | 97708
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Country | US
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Telephone | 503-508-7950
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Fax | 541-504-4516
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DIXIE LYNN HANNON
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Credential |
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Telephone | 503-508-7950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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