Organization
BAY CITIES MEDICAL SUPPLY. INC.
Active
Other names
Bay Cities Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE LATTA (OWNER)
(541) 269-1818
Entity
Organization
Contact information
Practice address
1180 AIRPORT WAY, NORTH BEND, OR 97459-2063
(541) 269-1818
Mailing address
PO BOX 575, COOS BAY, OR 97420-0115
(541) 269-1818
(541) 266-0386
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0605
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009365
—
OR
05
—
177188
—
OR
Enumeration date
03/26/2007
Last updated
08/22/2020
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