Kittitas County Hospital Dist 2
Organization Active NPI Land Ambulance · Cle Elum, WA
NPI 1700977204 · NPPES record last updated Feb 23, 2024
Key facts
- NPI
- 1700977204
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 19X01 (WA)
- Legal business name
- KITTITAS COUNTY HOSPITAL DIST 2
- Practice address
- 505 Power St
Cle Elum, WA 98922-1047 - Phone
- (509) 674-4057
- NPI assigned
- Sep 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Jason Adler
- Title
- Treasurer
- Phone
- (509) 962-7416
Practitioners 9
-
Catherine Sue Bilyard, ARNP
-
Forest James Hofer, P.A.
-
Jackson S Horsley, M.D.
-
Lance W Perrin, PA-C
-
Matthew M Rice, MD
-
Andrew C Schock, PA-C
-
Frederick P Fuller, PA-C
-
Eric Cameron Stroud, PA-C
-
Vee S Yoong, PA-C, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080211000157 | WA | Part B Supplier - Ambulance Service Supplier | 1456344381 | Practice locations: Cle Elum, WA |
National Provider Directory
Locations
617 Power St
Uppr
Cle Elum, WA 98922
Phone (509) 933-8619
111 Pine St
Cle Elum, WA 98922
Phone (509) 674-4057
505 Power St
Cle Elum, WA 98922
Phone (509) 674-4057
617 Power St
Cle Elum, WA 98922
Phone (509) 674-5950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 19X01 | WA | Yes |
Addresses
Primary practice location
505 Power St
Cle Elum, WA 98922-1047
Mailing address
PO Box 3510
Silverdale, WA 98383-3510
Phone (360) 394-7030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0082063 | Other | WA | WASHINGTON L&I |
| 590002307 | Other | WA | RAILROAD MEDICARE |
| 9075607 | Medicaid | WA |
Other providers in Cle Elum, WA
- Cynthia K Gregory
- Richard S. Grillo Jr.
- Sarah Mariah Heniges
- Julienne Jobin
- Wesley E Johnson
- Kittitas County Public Hospital Dist 1
- Koinonia Christian Camp and Retreat Center
- Erin M Krekling
- Emily Kuta
- Brandy Lindeman
All providers in Cle Elum, WA · Land Ambulance in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2024. 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.