Provider Demographics
NPI:1598717514
Name:CITY OF HOOD RIVER
Entity Type:Organization
Organization Name:CITY OF HOOD RIVER
Other - Org Name:HOOD RIVER AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-387-5252
Mailing Address - Street 1:211 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031
Mailing Address - Country:US
Mailing Address - Phone:541-386-9458
Mailing Address - Fax:541-387-4590
Practice Address - Street 1:1785 MEYER PKWY
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1316
Practice Address - Country:US
Practice Address - Phone:541-386-9458
Practice Address - Fax:541-387-4590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1403-063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
006161000OtherBLUE CROSS/BLUE SHIELD
OR078790Medicaid
590133448OtherPALMETTO GBA
WA9155003Medicaid
WA9155003Medicaid