Organization
PLYMOUTH TOWN CORPORATION
Active
Other names
Plymouth EMS
Organization subpart
No
Provider details
NPI number
Authorized official
JERIMY R ANDERSON (CHIEF)
(435) 239-7278
Entity
Organization
Contact information
Practice address
20120 N 5200 W, PLYMOUTH, UT 84330
(435) 239-7278
Mailing address
PO BOX 130, PLYMOUTH, UT 84330-0130
(435) 239-7278
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0205L
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U000073129
MEDICARE TYPE UNSPECIFIED
UT
Enumeration date
08/15/2006
Last updated
04/07/2011
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