MEDICARE: INLAND EMPIRE EMERGENCY SERVICES ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	AMB.ES.60028814	WA

General Provider Information

NPI Number	:	1336396902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INLAND EMPIRE EMERGENCY SERVICES ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 141316
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99214-1316
Country	:	US
Telephone Number	:	509-458-7866
Fax Number	:

Provider Business Practice Location Address
First Line	:	3510 S BATES RD
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-5944
Country	:	US
Telephone Number	:	509-458-7866
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF LOGISTICS
Name	:	MR. DAVID SALERNO
Credential	:
Telephone Number	:	509-458-7866

Provider Enumeration Date	:	08/26/2008
Last Update Date	:	04/06/2009

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