Lewis County Fire Protection District Number 15
Organization Active NPI Land Ambulance · Winlock, WA
NPI 1679956064 · NPPES record last updated May 10, 2023
Key facts
- NPI
- 1679956064
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- AMBV.ES.00000396 (WA)
- Legal business name
- LEWIS COUNTY FIRE PROTECTION DISTRICT NUMBER 15
- Practice address
- 609 NW Kerron St
Winlock, WA 98596-9450 - Phone
- (360) 785-4221
- NPI assigned
- Jul 2, 2015
- Organization subpart
- No
Authorized official
- Name
- Richard Underdahl
- Title
- Chief
- Phone
- (360) 269-2887
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160404000826 | WA | Part B Supplier - Ambulance Service Supplier | 1557668746 | Practice locations: Winlock, WA |
National Provider Directory
Locations
609 NW Kerron St
Winlock, WA 98596
Phone (360) 785-4221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | AMBV.ES.00000396 | WA | Yes |
Addresses
Primary practice location
609 NW Kerron St
Winlock, WA 98596-9450
Mailing address
PO Box 708
Winlock, WA 98596-0708
Phone (360) 785-4221
Other names
- Winlock Fire & Rescue
Other providers in Winlock, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.