Provider Demographics
NPI:1285636464
Name:MARION COUNTY FIRE DISTRICT NO 1
Entity Type:Organization
Organization Name:MARION COUNTY FIRE DISTRICT NO 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-588-6535
Mailing Address - Street 1:PO BOX 3510
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-3510
Mailing Address - Country:US
Mailing Address - Phone:360-394-7010
Mailing Address - Fax:360-394-7099
Practice Address - Street 1:300 CORDON RD NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97317-5203
Practice Address - Country:US
Practice Address - Phone:503-588-6526
Practice Address - Fax:503-588-6537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR114855Medicaid
OR590007829OtherRAILROAD MEDICARE PIN
OR590007829OtherRAILROAD MEDICARE PIN