City of Ilwaco

Organization Active NPI Land Ambulance · Ilwaco, WA

NPI 1609501931 · NPPES record last updated Oct 27, 2023

Key facts

NPI
1609501931
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
Legal business name
CITY OF ILWACO
Practice address
301 Spruce St E
Ilwaco, WA 98624-9177
Phone
(360) 642-3188
NPI assigned
Jul 20, 2022
Organization subpart
No

Authorized official

Name
Jeff Archer, FIRE CHIEF
Title
Fire Chief
Phone
(360) 518-7814

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230803003757 WA Part B Supplier - Ambulance Service Supplier 2567823743 Practice locations: Ilwaco, WA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Yes

Addresses

Primary practice location

301 Spruce St E
Ilwaco, WA 98624-9177

Mailing address

PO Box 584
Ilwaco, WA 98624-0584
Phone (360) 642-3145

Other names

  • Ilwaco Fire Department Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address Fireadmin@ilwaco-wa.gov systems design

Other providers in Ilwaco, WA

All providers in Ilwaco, WA · Land Ambulance in Washington

Sources for this page

Verify at the official NPI Registry.