Southern Wasco County Ambulance Service Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

3303-04 Issued in OR

Legal business name

SOUTHERN WASCO COUNTY AMBULANCE SERVICE INC

Practice address

390 3Rd St
Maupin, OR 97037-9246

Phone

(541) 395-2598

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Virginia Ann Fuller

Title

Secretary

Phone

(541) 395-2598

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1376625319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3510",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983833510",
            "telephone_number": "360-394-7030",
            "fax_number": "360-394-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 3RD ST",
            "city": "MAUPIN",
            "state": "OR",
            "postal_code": "970379246",
            "telephone_number": "541-395-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN WASCO COUNTY AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "541-395-2598"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OR",
            "license": "3303-04",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9032186",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179119",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Cate Henderson, L.C.S.W.
• Cheryl Corinne Laplante, DO
• South Wasco Community Health
• South Wasco County School District
• South Wasco County School District #1
• White River Health District

• Land Ambulance in Maupin, OR
• Providers in Maupin, OR by specialty
• Land Ambulance in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.