Provider Demographics
NPI:1578782991
Name:CITY OF OCEAN SHORES
Entity Type:Organization
Organization Name:CITY OF OCEAN SHORES
Other - Org Name:CITY OF OCEAN SHORES AMBULANCE BILLING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-289-3611
Mailing Address - Street 1:20855 KENSINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-7542
Mailing Address - Country:US
Mailing Address - Phone:833-469-7789
Mailing Address - Fax:952-985-5671
Practice Address - Street 1:800 ANCHOR AVE NW
Practice Address - Street 2:
Practice Address - City:OCEAN SHORES
Practice Address - State:WA
Practice Address - Zip Code:98569-9700
Practice Address - Country:US
Practice Address - Phone:360-289-3611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA14M08261QE0002X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA590002368OtherRAILROAD MEDICARE
WA9168808Medicaid
WA9168808Medicaid