City of Buckley

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

27M02 Issued in WA

Legal business name

CITY OF BUCKLEY

Doing business as

City of Buckley Fire Department

Practice address

611 S Division St
Buckley, WA 98321-9818

Phone

(360) 829-1441

Fax

(360) 829-6415

NPI assigned

Jul 26, 2011

Last updated

Dec 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alan Predmore

Title

Fire Chief

Phone

(360) 829-1441

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• City of Buckley Fire Department Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1932487873",
    "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": "360-394-7020",
            "fax_number": "360-394-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S DIVISION ST",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "983219818",
            "telephone_number": "360-829-1441",
            "fax_number": "360-829-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BUCKLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-26",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "PREDMORE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "360-829-1441"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WA",
            "license": "27M02",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2048863",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I/CRIME VICTIMS",
            "identifier": "0343971",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Buckley Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy Lynn Cargill, LPN
• Leah K Carthum
• Javaid Chaudhry, DDS
• Jimmy Dean Chubbuck, M.D.
• Chucks Drug (Chucks United Drugs)
• CLB Pharmaceutical Resources Inc (CLB Healthcare Resources)
• Jennifer Cochrane-Nicolls, M.S.W.
• Clare Elizabeth Coetzer, ARNP, LICSW
• Anna Marie Corey, COTA
• Mikaela Davison

• Land Ambulance in Buckley, WA
• Providers in Buckley, WA by specialty
• Land Ambulance in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.