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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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