Provider Demographics
NPI:1447332481
Name:CITY OF DUFUR
Entity type:Organization
Organization Name:CITY OF DUFUR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CITY RECORDER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BOSTICK GERACI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-467-2349
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:DUFUR
Mailing Address - State:OR
Mailing Address - Zip Code:97021-0145
Mailing Address - Country:US
Mailing Address - Phone:541-467-2349
Mailing Address - Fax:
Practice Address - Street 1:175 NE 3RD
Practice Address - Street 2:
Practice Address - City:DUFUR
Practice Address - State:OR
Practice Address - Zip Code:97021
Practice Address - Country:US
Practice Address - Phone:541-467-2349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3301-983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR58529Medicaid
ORR0000RGCDZMedicare ID - Type Unspecified
ORP00209141Medicare ID - Type UnspecifiedRAILROAD MEDICARE