South Beach Regional Fire Authority
Organization Active NPI Land Ambulance · Westport, WA
NPI 1013756204 · NPPES record last updated May 20, 2024
Key facts
- NPI
- 1013756204
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- SOUTH BEACH REGIONAL FIRE AUTHORITY
- Practice address
- 121 West Spokane Avenue
Westport, WA 98595 - Phone
- (360) 268-9832
- Fax
- (360) 268-1880
- NPI assigned
- May 20, 2024
- Organization subpart
- No
Authorized official
- Name
- Mr. Daryl Brown
- Title
- Battalion Chief
- Phone
- (360) 268-9832
Corporate family (same tax ID) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240828000748 | WA | Part B Supplier - Ambulance Service Supplier | 8628517265 | Practice locations: Grayland, WA; Westport, WA |
National Provider Directory
- Tax ID family
- South Beach Regional Fire Authority
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
121 West Spokane Avenue
Westport, WA 98595
Mailing address
PO Box 1195
Westport, WA 98595-1195
Phone (360) 268-9832
Other providers in Westport, WA
- Ocosta School District
- Duane W. Pegg
- Doris Elaine Reed
- Jessica Sison
- South Beach Dental Clinic
- South Beach Regional Fire Authority
- Aquila Stoneking
- Twin Harbor Drug, Inc.
- Angie Vogelsang
All providers in Westport, WA · Land Ambulance in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.