Provider Demographics
NPI:1467509026
Name:CITY OF POWERS
Entity Type:Organization
Organization Name:CITY OF POWERS
Other - Org Name:POWERS VOLUNTEER FIRE & AMBULANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF/AMBULANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-439-2031
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:POWERS
Mailing Address - State:OR
Mailing Address - Zip Code:97466-0250
Mailing Address - Country:US
Mailing Address - Phone:541-439-2031
Mailing Address - Fax:541-439-2031
Practice Address - Street 1:275 FIR ST
Practice Address - Street 2:
Practice Address - City:POWERS
Practice Address - State:OR
Practice Address - Zip Code:97466-0250
Practice Address - Country:US
Practice Address - Phone:541-439-2031
Practice Address - Fax:541-439-2031
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF POWERS VOLUNTEER FIRE & AMBULANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-05
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR06033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0603OtherAMBULANCE STATE NUMBER
R0000RGBKLMedicare UPIN
OR0000RGBKLMedicare ID - Type Unspecified