City of Elgin
Organization Active NPI Land Ambulance · Elgin, OR
NPI 1710068937 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1710068937
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 3103-06 (OR)
- Legal business name
- CITY OF ELGIN
- Practice address
- 180 N 8TH St
Elgin, OR 97827-0128 - Phone
- (541) 437-2253
- Fax
- (541) 437-2253
- NPI assigned
- Oct 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Joe Garlitz
- Title
- City Administrator
- Phone
- (541) 437-2253
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D0997517 | Elgin Ambulance Service | Certificate of waiver | Mar 18, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120324000058 | OR | Part B Supplier - Ambulance Service Supplier | 9133389471 | Practice locations: Elgin, OR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 3103-06 | OR | Yes |
Addresses
Primary practice location
180 N 8TH St
Elgin, OR 97827-0128
Mailing address
PO Box 128
Elgin, OR 97827-0128
Phone (541) 437-2253
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006108000 | Other | BLUE CROSS/BLUE SHIELD | |
| 756590712 | Other | PALMETTO GBA | |
| 055863 | Medicaid | OR |
Other names
- Elgin Ambulance Service
Other providers in Elgin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.