City of Ketchikan
Organization Active NPI Land Ambulance · Ketchikan, AK
NPI 1154487817 · NPPES record last updated Oct 8, 2012
Key facts
- NPI
- 1154487817
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- CITY OF KETCHIKAN
- Practice address
- 334 Front St
Ketchikan, AK 99901-6431 - Phone
- (907) 225-3111
- Fax
- (907) 228-5608
- NPI assigned
- Dec 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Robert E Newell Jr.
- Title
- Finance Director
- Phone
- (907) 225-3111
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090127000352 | AK | Part B Supplier - Ambulance Service Supplier | 5991790321 | Practice locations: Ketchikan, AK |
National Provider Directory
Locations
70 Bawden St
Ketchikan, AK 99901
Phone (907) 225-9616
334 Front St
Ketchikan, AK 99901
Phone (907) 225-3111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
334 Front St
Ketchikan, AK 99901-6431
Mailing address
PO Box 3510
Silverdale, WA 98383-3510
Phone (907) 225-3111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TR0301 | Medicaid | AK | |
| 590003575 | Other | RAILROAD MEDICARE PTAN |
Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2012. 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.