Organization
TEKOA COMMUNITY AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAYNE GROOM (PRESIDENT)
(509) 284-2246
Entity
Organization
Contact information
Practice address
S 226 RAMSEY STR., TEKOA, WA 99033-0597
(509) 284-2423
Mailing address
S. 226 RAMSEY ST., PO BOX 597, TEKOA, WA 99033-0597
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9257601
—
WA
Enumeration date
06/25/2007
Last updated
08/22/2020
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