Organization Active NPI

Grant County Fire District No 10

Doing business as Grant County Fire District # 10 Ambulance

  • Land Ambulance
  • Royal City, WA
National Provider Identifier
1710075254
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
13D10 Issued in WA
Legal business name
GRANT COUNTY FIRE DISTRICT NO 10
Doing business as
Grant County Fire District # 10 Ambulance
Practice address
336 Camelia St NE
Royal City, WA 99357-0220
Phone
(509) 346-2658
Fax
(509) 346-2129
NPI assigned
Oct 10, 2006
Last updated
Nov 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Brian Evans
Title
Fire Chief
Phone
(509) 346-2658

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 13D10 WA Primary

Addresses

Primary practice location

336 Camelia St NE
Royal City, WA 99357-0220

Mailing address

PO Box 220
Royal City, WA 99357-0220
Phone (509) 346-2658

Other identifiers 2

IdentifierTypeStateIssuer
84473OtherWAWASHINGTON L&I
9163304MedicaidWA

Other names 1

  • GRANT COUNTY FIRE DISTRICT # 10 AMBULANCE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081212000688 WA Part B Supplier - Ambulance Service Supplier 5698836369 Practice locations: Othello, WA; Royal City, WA

National Provider Directory

National Provider Directory

Locations

7012 Highway 262 E
Othello, WA 99344
Phone (509) 346-2658

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385424000000",
    "number": "1710075254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "ROYAL CITY",
            "state": "WA",
            "postal_code": "993570220",
            "telephone_number": "509-346-2658",
            "fax_number": "509-346-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 CAMELIA ST NE",
            "city": "ROYAL CITY",
            "state": "WA",
            "postal_code": "993570220",
            "telephone_number": "509-346-2658",
            "fax_number": "509-346-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT COUNTY FIRE DISTRICT NO 10",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-11-26",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "509-346-2658",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "13D10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L&I",
            "identifier": "84473",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9163304",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRANT COUNTY FIRE DISTRICT # 10 AMBULANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Royal City, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.

Verify at the official NPI Registry.