Organization
MID COLUMBIA AMBULANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN EGLI (CHIEF)
(509) 586-6982
Entity
Organization
Contact information
Practice address
822 W JOHN DAY AVE, KENNEWICK, WA 99336-3577
(509) 586-6982
(509) 586-8314
Mailing address
PO BOX 6718, KENNEWICK, WA 99336-0640
(509) 586-6982
(509) 586-8314
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
294920
PREMERA BC
WA
05
—
9056169
—
WA
Enumeration date
11/08/2006
Last updated
10/17/2007
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