City of Ruston

Organization Active NPI Land Ambulance · Ruston, WA

NPI 1972368504 · NPPES record last updated Jun 25, 2024

Key facts

NPI
1972368504
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
Legal business name
CITY OF RUSTON
Practice address
5117 N Winnifred St
Ruston, WA 98407-6512
Phone
(253) 330-7755
NPI assigned
Feb 13, 2024
Organization subpart
Yes
Parent organization (as reported)
RUSTON FIRE DEPARTMENT

Authorized official

Name
Bruce E. Allen, FIRE CHIEF
Title
Fire Chief
Phone
(253) 330-7755

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240826001751 WA Part B Supplier - Ambulance Service Supplier 8921547787 Practice locations: Ruston, WA

National Provider Directory

Part of
City of Ruston

Locations

5117 N Winnifred St
Ruston, WA 98407
Phone (253) 330-7755

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Yes

Addresses

Primary practice location

5117 N Winnifred St
Ruston, WA 98407-6512

Mailing address

5219 N Shirley St
Ruston, WA 98407-6599
Phone (253) 330-7755

Other names

  • Ruston Fire Department Doing business as

Other providers in Ruston, WA

All providers in Ruston, WA · Land Ambulance in Washington

Sources for this page

Verify at the official NPI Registry.