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NPI Code Detail

MEDICARE: RAND W DICKSON INTERSTATE MEDICAL TRANSPORT

MEDICARE: RAND W DICKSON INTERSTATE MEDICAL TRANSPORT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13416L0300XLand Ambulance

General Provider Information

NPI Number : 1619748084
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAND W DICKSON INTERSTATE MEDICAL TRANSPORT
Provider Business Mailing Address
First Line : PO BOX 2458
Second Line :
City : EUREKA
State : MT
Zip : 59917-2458
Country : US
Telephone Number : 406-297-1627
Fax Number :
Provider Business Practice Location Address
First Line : 600 MAIN ST
Second Line :
City : DEER LODGE
State : MT
Zip : 59722-1440
Country : US
Telephone Number : 406-691-9304
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RAND DICKSON
Credential :
Telephone Number : 406-740-2646
Provider Enumeration Date : 01/12/2024
Last Update Date : 02/02/2024

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Directions to “RAND W DICKSON INTERSTATE MEDICAL TRANSPORT ” Practice Location

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