Provider Demographics
NPI:1891746616
Name:CHEMULT RURAL FIRE PROTECTION DIST
Entity Type:Organization
Organization Name:CHEMULT RURAL FIRE PROTECTION DIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORT
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:541-365-2255
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:CHEMULT
Mailing Address - State:OR
Mailing Address - Zip Code:97731
Mailing Address - Country:US
Mailing Address - Phone:541-365-2255
Mailing Address - Fax:541-365-2260
Practice Address - Street 1:109800 HIGHWAY 97N
Practice Address - Street 2:
Practice Address - City:CHEMULT
Practice Address - State:OR
Practice Address - Zip Code:97731
Practice Address - Country:US
Practice Address - Phone:541-365-2255
Practice Address - Fax:541-365-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR063560Medicaid
OR063560Medicaid