# MID VALLEY AMBULANCE SERVICE INC.

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

## Provider details

- **NPI number:** 1104304682
- **Authorized official:** JD FUITEN (OWNER)
- **Authorized official phone:** (541) 648-6658

## Contact information

- **Practice address:** 280 JEFFERSON ST, EUGENE, OR 97402-5027
- **Practice address phone:** (541) 747-4025
- **Mailing address:** 3505 OCEAN BLVD SE, COOS BAY, OR 97420-3537
- **Mailing address phone:** (541) 266-4300
- **Mailing address fax:** (541) 267-0831

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 3639 | OR | Yes |

## Other

- **Enumeration date:** 08/06/2018
- **Last updated:** 02/15/2024