Eagle Valley Ambulance

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

EAGLE VALLEY AMBULANCE

Practice address

42000 Moody Rd
Richland, OR 97870-6601

Phone

(541) 239-8349

NPI assigned

Aug 6, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Tammy Graven

Title

Treasurer

Phone

(541) 403-2604

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1710178686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 334",
            "city": "RICHLAND",
            "state": "OR",
            "postal_code": "97870",
            "telephone_number": "541-403-2604",
            "fax_number": "541-523-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42000 MOODY RD",
            "city": "RICHLAND",
            "state": "OR",
            "postal_code": "978706601",
            "telephone_number": "541-239-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE VALLEY AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "GRAVEN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "541-403-2604",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222216",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.