Organization
COUNTY OF TETON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R UNGARETTI CCEMTP (GENERAL MANAGER)
(406) 549-7104
Entity
Organization
Contact information
Practice address
HWY 89 COUNTY COURTHOUSE, CHOTEAU, MT 59422
(406) 466-5552
Mailing address
PO BOX 1359, 1243 BURLINGTON AVE, MISSOULA, MT 59806-1359
(406) 549-7104
(406) 542-2785
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
40
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442949
—
MT
01
—
1482
BCBS
MT
01
—
184998200
OWAP
MT
Enumeration date
05/04/2006
Last updated
02/13/2013
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