# CROOKED RIVER RANCH FIRE PROTECTION DISTRICT VI-503

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Crooked River Ranch RFPD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861587578
- **Authorized official:** MR. MARK W WILSON (FIRE CHIEF)
- **Authorized official phone:** (541) 923-6776

## Contact information

- **Practice address:** 6971 SW SHAD RD, TERREBONNE, OR 97760-7792
- **Practice address phone:** (541) 923-6776
- **Practice address fax:** (541) 923-5247
- **Mailing address:** 6971 SW SHAD RD, TERREBONNE, OR 97760-7792
- **Mailing address phone:** (541) 923-6776
- **Mailing address fax:** (541) 923-5247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 1613-06 | OR | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 04/01/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 081971000 | BLUE CROSS/BLUE SHIELD | — |
| 05 | — | 177220 | — | OR |
| 01 | — | 59008157 | PALMETTO GBA | — |