MEDICARE: KEIZER RURAL FIRE PROTECTION DIST

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	241306	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590011519	OTHER	OR	RAILROAD MEDICARE PIN

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	:	1649273004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEIZER RURAL FIRE PROTECTION DIST

Provider Business Mailing Address
First Line	:	661 CHEMAWA RD NE
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303-4436
Country	:	US
Telephone Number	:	503-390-9111
Fax Number	:	503-390-8299

Provider Business Practice Location Address
First Line	:	661 CHEMAWA RD NE
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303-4436
Country	:	US
Telephone Number	:	503-390-9111
Fax Number	:	503-390-8299

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MR. JEFF S COWAN
Credential	:
Telephone Number	:	503-390-9111

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/30/2013

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Directions to “KEIZER RURAL FIRE PROTECTION DIST ” Practice Location

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