Provider Demographics
NPI:1003815416
Name:CITY OF HUNTINGTON AMBULANCE DEPARTMENT
Entity Type:Organization
Organization Name:CITY OF HUNTINGTON AMBULANCE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-869-2001
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:OR
Mailing Address - Zip Code:97907-0369
Mailing Address - Country:US
Mailing Address - Phone:541-869-2202
Mailing Address - Fax:
Practice Address - Street 1:10 E ADAMS
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:OR
Practice Address - Zip Code:97907
Practice Address - Country:US
Practice Address - Phone:541-869-2001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF HUNTINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-18
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000RGBDQMedicare ID - Type Unspecified