Provider Demographics
NPI:1760586994
Name:CASCADE RURAL FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:CASCADE RURAL FIRE PROTECTION DISTRICT
Other - Org Name:CASCADE RURAL FIRE & EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:L KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-337-4254
Mailing Address - Street 1:PO BOX 825
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:ID
Mailing Address - Zip Code:83611-0825
Mailing Address - Country:US
Mailing Address - Phone:208-382-3200
Mailing Address - Fax:
Practice Address - Street 1:109 E PINE
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:ID
Practice Address - Zip Code:83611
Practice Address - Country:US
Practice Address - Phone:208-630-3837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID#74103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010014874OtherBLUE SHIELD
ID0025768Medicaid
OR244075OtherDMAP
ID4731133OtherMEDICAL
ID590014894OtherRAILROAD MEDICARE
IDE7414OtherBLUE CROSS
OR244075OtherDMAP