Provider Demographics
NPI:1013040500
Name:EMERGENCY ROOMS, PS
Entity Type:Organization
Organization Name:EMERGENCY ROOMS, PS
Other - Org Name:FAMILY CARE & URGENT MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIGONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-695-9922
Mailing Address - Street 1:4421 NE ST JOHNS RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-2573
Mailing Address - Country:US
Mailing Address - Phone:360-695-9922
Mailing Address - Fax:360-695-1310
Practice Address - Street 1:4421 NE ST JOHNS RD
Practice Address - Street 2:SUITE F
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-2573
Practice Address - Country:US
Practice Address - Phone:360-695-9922
Practice Address - Fax:360-695-1310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0829670001OtherMEDICARE TYPE UNSPECIFIED
WA0829670001Medicare NSC
WAG000681400Medicare PIN