Provider Demographics
NPI:1649229253
Name:CENTRAL OREGON COAST FIRE AND RESCUE DISTRICT
Entity Type:Organization
Organization Name:CENTRAL OREGON COAST FIRE AND RESCUE DISTRICT
Other - Org Name:CENTRAL OREGON COAST FIRE AND RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-563-3121
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:WALDPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97394-0505
Mailing Address - Country:US
Mailing Address - Phone:541-563-3121
Mailing Address - Fax:541-563-3190
Practice Address - Street 1:145 E ALSEA HWY
Practice Address - Street 2:
Practice Address - City:WALDPORT
Practice Address - State:OR
Practice Address - Zip Code:97394-9805
Practice Address - Country:US
Practice Address - Phone:541-563-3121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2109-063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR295495Medicaid
OR295495Medicaid