# SOUTH GILLIAM COUNTY AMBULANCE

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

## Provider details

- **NPI number:** 1467505883
- **Authorized official:** CINDY HESS (INSURANCE CLERK)
- **Authorized official phone:** (541) 384-2061

## Contact information

- **Practice address:** 422 N MAIN, CONDON, OR 97823-0085
- **Practice address phone:** (541) 384-2061
- **Mailing address:** PO BOX 85, CONDON, OR 97823-0085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 1104 | OR | Yes |

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 05/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 070664 | — | OR |