Provider Demographics
NPI:1427265560
Name:LINCOLN COUNTY FIRE PROTECTION FIRE SERVICE & AMBULANCE SERVICE
Entity type:Organization
Organization Name:LINCOLN COUNTY FIRE PROTECTION FIRE SERVICE & AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ARLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-257-2926
Mailing Address - Street 1:124 OLD AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:SPRAGUE
Mailing Address - State:WA
Mailing Address - Zip Code:99032-4904
Mailing Address - Country:US
Mailing Address - Phone:509-257-2926
Mailing Address - Fax:509-257-2865
Practice Address - Street 1:124 OLD AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SPRAGUE
Practice Address - State:WA
Practice Address - Zip Code:99032-4904
Practice Address - Country:US
Practice Address - Phone:509-257-2926
Practice Address - Fax:509-257-2865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA22D013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0211220OtherL&I AND CRIMEVICTIMS
WA01057710OtherRAILROAD MEDICARE PTAN
WA1028321Medicaid
WAG8889478Medicare PIN