Deer Park Volunteer Ambulance
Organization Active NPI Land Ambulance · Deer Park, WA
NPI 1184714438 · NPPES record last updated Oct 20, 2017
Key facts
- NPI
- 1184714438
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 32X07 (WA)
- Legal business name
- DEER PARK VOLUNTEER AMBULANCE
- Practice address
- 19 N. Arnim
Deer Park, WA 99006-0596 - Phone
- (509) 276-2789
- NPI assigned
- Oct 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Steve Cooke
- Title
- Director of Operations
- Phone
- (509) 276-2789
Practitioners 1
-
Brian Barton, IDMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080530000406 | WA | Part B Supplier - Ambulance Service Supplier | 1052481264 | Practice locations: Deer Park, WA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 32X07 | WA | Yes |
Addresses
Primary practice location
19 N. Arnim
Deer Park, WA 99006-0596
Mailing address
PO Box 596
Deer Park, WA 99006-0596
Phone (509) 276-2789
Other providers in Deer Park, WA
- Deer Park Dental PLLC
- Deer Park Family Care Clinic PS
- Deer Park Physical Therapy Inc
- Deer Park School District
- Deer Park Urgent Care PLLC
- Jeremy Rae Deerheim
- Anthony Demuri
- Kathryn Derosier
- Cody B Devore
- Stephanie Dawn Doud
All providers in Deer Park, 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 Oct 20, 2017. 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.