Thurston County Fire Protection District 12
Organization Active NPI Land Ambulance · Tenino, WA
NPI 1124574413 · NPPES record last updated Aug 28, 2016
Key facts
- NPI
- 1124574413
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 34D12 (WA)
- Legal business name
- THURSTON COUNTY FIRE PROTECTION DISTRICT 12
- Practice address
- 187 Hodgden St S
Tenino, WA 98589 - Phone
- (360) 264-4116
- NPI assigned
- Aug 28, 2016
- Organization subpart
- No
Authorized official
- Name
- Andrew Schaffran
- Title
- Fire Chief
- Phone
- (360) 264-4116
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161104000893 | WA | Part B Supplier - Ambulance Service Supplier | 0547548950 | Practice locations: Centralia, WA; Tenino, WA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 34D12 | WA | Yes |
Addresses
Primary practice location
187 Hodgden St S
Tenino, WA 98589
Mailing address
PO Box 3510
Silverdale, WA 98383-3510
Phone (360) 394-7020
Other names
- South County Fire & EMS
Other providers in Tenino, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2016. 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.