MEDICARE: CITY OF KENAI

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	0020	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619979184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF KENAI

Provider Business Mailing Address
First Line	:	PO BOX 3510
Second Line	:
City	:	SILVERDALE
State	:	WA
Zip	:	98383-3510
Country	:	US
Telephone Number	:	800-238-9398
Fax Number	:	360-394-7097

Provider Business Practice Location Address
First Line	:	210 FIDALGO AVE
Second Line	:
City	:	KENAI
State	:	AK
Zip	:	99611-7750
Country	:	US
Telephone Number	:	907-283-8228
Fax Number	:

Authorized Official
Title or Position	:	DISTRICT SECRETARY
Name	:	REBECCA J BUSH
Credential	:
Telephone Number	:	907-335-5234

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	12/12/2025

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Directions to “CITY OF KENAI ” Practice Location

Language	Start Address	Practice Location

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