Organization
SOUTHERN WASCO COUNTY AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA ANN FULLER (SECRETARY)
(541) 395-2598
Entity
Organization
Contact information
Practice address
390 3RD ST, MAUPIN, OR 97037-9246
(541) 395-2598
Mailing address
PO BOX 3510, SILVERDALE, WA 98383-3510
(360) 394-7030
(360) 394-7094
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
3303-04
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179119
—
OR
05
—
9032186
—
WA
Enumeration date
10/19/2006
Last updated
02/16/2024
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