# OLANCHA COMMUNITY SERVICE DISTRICT

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

## Provider details

- **NPI number:** 1326036203
- **Authorized official:** MRS. LORIE VERKUYL (BILLING AGENT)
- **Authorized official phone:** (760) 375-3776

## Contact information

- **Practice address:** 610 SHOP ST, OLANCHA, CA 93549
- **Practice address phone:** (760) 764-2370
- **Mailing address:** PO BOX 64, OLANCHA, CA 93549-0064
- **Mailing address phone:** (760) 764-2370
- **Mailing address fax:** (760) 375-3746

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2005
- **Last updated:** 05/02/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | MTE00957F | — | CA |