Provider Demographics
NPI:1669459822
Name:CITY OF EUGENE
Entity Type:Organization
Organization Name:CITY OF EUGENE
Other - Org Name:EUGENE FIRE & EMS DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN DIVISION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:FOLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-682-7107
Mailing Address - Street 1:1705 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-4177
Mailing Address - Country:US
Mailing Address - Phone:541-682-7100
Mailing Address - Fax:541-682-7168
Practice Address - Street 1:1705 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4177
Practice Address - Country:US
Practice Address - Phone:541-682-7100
Practice Address - Fax:541-682-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2007-063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR261834Medicaid
ORR117146Medicare ID - Type UnspecifiedPROVIDER NUMBER