# NORTH DOUGLAS COUNTY FIRE AND EMS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073672747
- **Authorized official:** ROBERT M SHANNON (CHIEF)
- **Authorized official phone:** (541) 836-2282

## Contact information

- **Practice address:** 531 S CEDAR ST., DRAIN, OR 97435
- **Practice address phone:** (541) 836-2282
- **Practice address fax:** (541) 836-2292
- **Mailing address:** PO BOX 277, DRAIN, OR 97435-0277
- **Mailing address phone:** (541) 836-2282
- **Mailing address fax:** (541) 836-2292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 0006-06 | OR | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 02/04/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 013427000 | BLUE CROSS BLUE SHIELD | OR |
| 05 | — | 135546 | — | OR |
| 01 | — | 590010959 | PALMETTO GBA | OR |