Lewis County Fire Protection District 11

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LEWIS COUNTY FIRE PROTECTION DISTRICT 11

Practice address

800 Main Street
Pe Ell, WA 98572

Phone

(360) 291-2906

Fax

(360) 291-2906

NPI assigned

Jul 22, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard Underdahl

Title

Mso

Phone

(971) 404-8581

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1336757616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "PE ELL",
            "state": "WA",
            "postal_code": "985720308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN STREET",
            "city": "PE ELL",
            "state": "WA",
            "postal_code": "98572",
            "telephone_number": "360-291-2906",
            "fax_number": "360-291-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS COUNTY FIRE PROTECTION DISTRICT 11",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "UNDERDAHL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MSO",
        "authorized_official_telephone_number": "971-404-8581"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry Eugene Kerschner, A.R.N.P.
• Lewis County Community Health Services (Valley View Health Center - Pe Ell)
• Lusk Enterprises PS Inc
• Suzanne J Nelson
• Pe Ell Ambulance Auxillary
• Pe Ell School District

• Land Ambulance in Pe Ell, WA
• Providers in Pe Ell, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.