Provider Demographics
NPI:1023332392
Name:NEWPORT EMERGENCY SERVICES INC
Entity type:Organization
Organization Name:NEWPORT EMERGENCY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GROOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-447-4108
Mailing Address - Street 1:203 E 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:OLDTOWN
Mailing Address - State:ID
Mailing Address - Zip Code:83822-9546
Mailing Address - Country:US
Mailing Address - Phone:509-447-4108
Mailing Address - Fax:208-437-0886
Practice Address - Street 1:203 E 4TH ST N
Practice Address - Street 2:
Practice Address - City:OLDTOWN
Practice Address - State:ID
Practice Address - Zip Code:83822-9546
Practice Address - Country:US
Practice Address - Phone:509-447-4108
Practice Address - Fax:208-437-0886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA26X023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport