Pe Ell Ambulance Auxillary

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

21M05 Issued in WA

Legal business name

PE ELL AMBULANCE AUXILLARY

Practice address

800 N Main St
Pe Ell, WA 98572

Phone

(360) 520-2046

NPI assigned

Jul 27, 2007

Organization subpart

No

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

Authorized official

Name

Michael Krafczyk

Title

Fire Chief

Phone

(360) 880-0036

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1780874511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3510",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983833510",
            "telephone_number": "360-394-7030",
            "fax_number": "360-394-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "PE ELL",
            "state": "WA",
            "postal_code": "98572",
            "telephone_number": "360-520-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PE ELL AMBULANCE AUXILLARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "KRAFCZYK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "360-880-0036"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "21M05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0239919",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00840008",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9062365",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry Eugene Kerschner, A.R.N.P.
• Lewis County Community Health Services (Valley View Health Center - Pe Ell)
• Lewis County Fire Protection District 11
• Lusk Enterprises PS Inc
• Suzanne J Nelson
• Pe Ell School District

• Land Ambulance in Pe Ell, WA
• Providers in Pe Ell, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.