Active NPI
City of Grand Coulee
- Land Ambulance
- Grand Coulee, WA
National Provider Identifier
1801896873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 13M05
- Legal business name
- CITY OF GRAND COULEE
- Practice address
- 306 Midway Avenue
Grand Coulee, WA 99133-0180 - Phone
- (509) 633-1150
- Fax
- (509) 633-1370
- NPI assigned
- Jul 29, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Richard Paris, EMT
- Title
- Ambulance Director
- Phone
- (509) 633-1150
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 13M05 | WA | Primary |
Addresses
Primary practice location
306 Midway Avenue
Grand Coulee, WA 99133-0180
Mailing address
PO Box 3510
Silverdale, WA 98383-3510
Phone (360) 394-7030
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0028478 | Other | WA | L&I-CRIME VICTIMS |
| 9114505 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120222000646 | WA | Part B Supplier - Ambulance Service Supplier | 4880852896 | Practice locations: Grand Coulee, WA |
National Provider Directory
National Provider DirectoryLocations
306 Midway Ave
Grand Coulee, WA 99133
Phone (509) 633-1105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1330560000000",
"number": "1801896873",
"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": "306 MIDWAY AVENUE",
"city": "GRAND COULEE",
"state": "WA",
"postal_code": "991330180",
"telephone_number": "509-633-1150",
"fax_number": "509-633-1370"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF GRAND COULEE",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-29",
"last_updated": "2012-03-01",
"status": "A",
"authorized_official_last_name": "PARIS",
"authorized_official_first_name": "RICHARD",
"authorized_official_title_or_position": "AMBULANCE DIRECTOR",
"authorized_official_telephone_number": "509-633-1150",
"authorized_official_credential": "EMT"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "WA",
"license": "13M05",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-CRIME VICTIMS",
"identifier": "0028478",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9114505",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Coulee, WA
- David Martin Brown, CRNA
- Samantha B Brunner, PA-C
- Andrew Cecil Castrodale, MD
- Jacob Petersen Chaffee, MD
- Cheney Owl Pharmacy Inc
- Kathleen Kelly Cohen, D.O.
- Dee Deife, BA
- Charlene Marie Desautel, PT
- Douglas, Grant, Lincolc and Okanogan Couties Public Hosp. Dist. #6
- Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.