Healthcare Provider Details
I. General information
NPI: 1245427996
Provider Name (Legal Business Name): LIMA RURAL FIRE DEPT AND AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2007
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 N BROADWAY
LIMA MT
59739-0161
US
IV. Provider business mailing address
PO BOX 161
LIMA MT
59739-0161
US
V. Phone/Fax
- Phone: 406-276-3449
- Fax: 650-471-6245
- Phone: 406-276-3449
- Fax: 650-471-6245
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 453 |
| License Number State | MT |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
LINDA
L
COCHRAN
Title or Position: AMBULANCE DIRECTOR
Credential: MED-AEMT-LIC-335 MT
Phone: 406-276-3490