Organization
BONANZA QUICK RESPONSE TEAM
Active
Parent organization
BONANZA QUICK RESPONSE TEAM
Other names
Bonanza Ambulance
Organization subpart
Yes
Provider details
NPI number
Legal business name
BONANZA QUICK RESPONSE TEAM
Authorized official
PAMELA FAYE WIERSMA (PRESIDENT)
(541) 892-8106
Entity
Organization
Contact information
Practice address
3100 E. LANGELL VALLEY RD., BONANZA, OR 97623
(541) 892-5537
(541) 545-6553
Mailing address
PO BOX 363, BONANZA, OR 97623
(541) 892-5537
(541) 545-6553
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
T520620
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165100
—
OR
Enumeration date
11/07/2006
Last updated
07/08/2016
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