Provider Demographics
NPI:1336784495
Name:WESTERN LANE FIRE AND EMS AUTHORITY
Entity Type:Organization
Organization Name:WESTERN LANE FIRE AND EMS AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE & EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:SCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-997-3212
Mailing Address - Street 1:2625 HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-9702
Mailing Address - Country:US
Mailing Address - Phone:541-997-3212
Mailing Address - Fax:541-997-9116
Practice Address - Street 1:2625 HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9702
Practice Address - Country:US
Practice Address - Phone:541-997-3212
Practice Address - Fax:541-997-9116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency