Provider Demographics
NPI:1558474403
Name:ARLINGTON AMBULANCE SERVICE
Entity Type:Organization
Organization Name:ARLINGTON AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL SIGNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RENDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-454-8222
Mailing Address - Street 1:500 W. FIRST ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:OR
Mailing Address - Zip Code:97812
Mailing Address - Country:US
Mailing Address - Phone:541-454-2888
Mailing Address - Fax:
Practice Address - Street 1:500 W. FIRST ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:OR
Practice Address - Zip Code:97812
Practice Address - Country:US
Practice Address - Phone:541-454-2888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1101-033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR041236Medicaid
WA9041310Medicaid
ORR0000RGBLQMedicare ID - Type Unspecified