Organization
POWELL COUNTY AMBULANCE SERVICE INC
Active
Organization
POWELL COUNTY AMBULANCE SERVICE INC
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
1101 TEXAS AVE, DEER LODGE, MT 59722
(406) 846-2212
(406) 846-6039
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
043
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000445510
—
MT
01
—
00124-2
BC/BS
MT
05
—
80708400
—
ID
Enumeration date
06/06/2006
Last updated
05/24/2013
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