Organization
SUPERIOR VOLUNTEER FIRE COMPANY INC
Active
Other names
Superior Area Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK ALAN METZGER (CHAIRMAN)
(406) 822-3001
Entity
Organization
Contact information
Practice address
1202 5TH AVE E., SUPERIOR, MT 59872
(406) 822-3570
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
92
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001372
BC/BS
MT
05
—
0440687
—
MT
01
—
155606200
OWCP
MT
05
—
806874000
—
ID
05
—
9047754
—
WA
Enumeration date
06/06/2006
Last updated
03/14/2023
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