Active NPI
Lewis County Fire Protection District 14
Doing business as Randle Fire & EMS
- Land Ambulance
- Randle, WA
National Provider Identifier
1508853193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 21D14
- Legal business name
- LEWIS COUNTY FIRE PROTECTION DISTRICT 14
- Doing business as
- Randle Fire & EMS
- Practice address
- 9978 US Hwy 12
Randle, WA 98377-0127 - Phone
- (360) 497-7745
- NPI assigned
- Sep 29, 2005
- Last updated
- May 16, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Penny Owens
- Title
- District Secretary
- Phone
- (360) 497-7745
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 21D14 | WA | Primary |
Addresses
Primary practice location
9978 US Hwy 12
Randle, WA 98377-0127
Mailing address
PO Box 3510
Silverdale, WA 98383-3510
Phone (360) 394-7030
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9187006 | Medicaid | WA | |
| WA00106 | Other | WA | SUBMITTER NUMBER |
| LE9337 | Other | WA | REGENCE |
| 29939 | Other | WA | L&I AND CRIME VICTIMS |
Other names 1
- RANDLE FIRE & EMS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070611000056 | WA | Part B Supplier - Ambulance Service Supplier | 6901904267 | Practice locations: Randle, WA |
National Provider Directory
National Provider Directory- Tax ID family
- Lewis County Fire Protection District 14
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- Randle, WA
- NPI 1073376299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1305504000000",
"number": "1508853193",
"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": "360-394-7097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9978 US HWY 12",
"city": "RANDLE",
"state": "WA",
"postal_code": "983770127",
"telephone_number": "360-497-7745"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEWIS COUNTY FIRE PROTECTION DISTRICT 14",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-29",
"last_updated": "2011-05-16",
"status": "A",
"authorized_official_last_name": "OWENS",
"authorized_official_first_name": "PENNY",
"authorized_official_title_or_position": "DISTRICT SECRETARY",
"authorized_official_telephone_number": "360-497-7745",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "WA",
"license": "21D14",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9187006",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUBMITTER NUMBER",
"identifier": "WA00106",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "LE9337",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I AND CRIME VICTIMS",
"identifier": "29939",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RANDLE FIRE & EMS",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Randle, WA
- Daryl Gene Conklin, PAC
- Emily Olivia Dames, PA-C
- Pamala Hedglin, MSW
- Ryan P Lemert, DMD
- Lewis County Fire Protection District 14
- Lewis County Hospital District No. 1 (Arbor Health Randle Clinic)
- Lewis County Hospital District No. 1 (Arbor Health Randle Clinic)
- Travis Podbilski, DO
- Randle Dental Clinic
- White Pass School District
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.