Provider Demographics
NPI:1609501931
Name:CITY OF ILWACO
Entity Type:Organization
Organization Name:CITY OF ILWACO
Other - Org Name:ILWACO FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:FIRE CHIEF
Authorized Official - Phone:360-518-7814
Mailing Address - Street 1:PO BOX 584
Mailing Address - Street 2:
Mailing Address - City:ILWACO
Mailing Address - State:WA
Mailing Address - Zip Code:98624-0584
Mailing Address - Country:US
Mailing Address - Phone:360-642-3145
Mailing Address - Fax:360-642-3155
Practice Address - Street 1:301 SPRUCE ST E
Practice Address - Street 2:
Practice Address - City:ILWACO
Practice Address - State:WA
Practice Address - Zip Code:98624-9177
Practice Address - Country:US
Practice Address - Phone:360-642-3188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport