Healthcare Provider Details
I. General information
NPI: 1225106511
Provider Name (Legal Business Name): MARION AMBULANCE & RESCUE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/03/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
660 GOPHER LN
MARION MT
59925-9789
US
IV. Provider business mailing address
PO BOX 933
MARION MT
59925-0933
US
V. Phone/Fax
- Phone: 406-854-2894
- Fax:
- Phone: 406-854-2894
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 027 |
| License Number State | MT |
VIII. Authorized Official
Name:
GARY
R
TROUTMAN
Title or Position: PRESIDENT
Credential:
Phone: 406-854-2894