City of Homer

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0260 Issued in AK

Legal business name

CITY OF HOMER

Practice address

491 E Pioneer Ave
Homer, AK 99603-7624

Phone

(907) 235-8121

Fax

(907) 235-3140

NPI assigned

Aug 8, 2006

Last updated

Mar 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Regina Harville

Title

Finance Director

Phone

(907) 235-8121

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HOMER VOLUNTEER FIRE DEPARTMENT Other name

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Locations

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1346250982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 E PIONEER AVE",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037624",
            "telephone_number": "907-235-8121",
            "fax_number": "907-435-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 E PIONEER AVE",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037624",
            "telephone_number": "907-235-8121",
            "fax_number": "907-235-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF HOMER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "HARVILLE",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "907-235-8121"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "AK",
            "license": "0260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TR0115",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOMER VOLUNTEER FIRE DEPARTMENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Land Ambulance in Homer, AK
• Providers in Homer, AK by specialty
• Land Ambulance in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.