Healthcare Provider Details
I. General information
NPI: 1972542637
Provider Name (Legal Business Name): ARLEE VOLUNTEER FIRE & AMBULANCE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20754 HWY 93 N
ARLEE MT
59821-0254
US
IV. Provider business mailing address
PO BOX 1359 1243 BURLINGTON AVE
MISSOULA MT
59806-1359
US
V. Phone/Fax
- Phone: 406-726-3353
- Fax: 406-726-4350
- Phone: 406-549-7104
- Fax: 406-542-2785
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 121 |
| License Number State | MT |
VIII. Authorized Official
Name:
JOHN
R
UNGARETTI
Title or Position: GENERAL MANAGER
Credential: CCEMTP
Phone: 406-549-7104