Organization
CRESCENT RURAL FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LEWIS PETERSEN (PRESIDENT, BOARD OF DIRECTORS)
(541) 433-2466
Entity
Organization
Contact information
Practice address
150 MOUNTAIN VIEW DR, GILCHRIST, OR 97737-3244
(541) 433-2466
(541) 433-2600
Mailing address
PO BOX 811, GILCHRIST, OR 97737-0811
(541) 433-2466
(541) 433-2600
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1830
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073603528
MEDICARE
OR
05
—
171017
—
OR
05
—
50220
—
OR
05
—
800382
—
OR
Enumeration date
10/13/2006
Last updated
10/10/2018
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