Healthcare Provider Details

I. General information

NPI: 1285887364
Provider Name (Legal Business Name): MARION VOLUNTEER FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 GOPHER LANE
MARION MT
59925-0000
US

IV. Provider business mailing address

1008 BURLINGTON AVE STE C
MISSOULA MT
59801-5682
US

V. Phone/Fax

Practice location:
  • Phone: 406-854-2828
  • Fax: 406-854-9330
Mailing address:
  • Phone: 406-549-7104
  • Fax: 406-542-2785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number505
License Number StateMT

VIII. Authorized Official

Name: MR. LARRY BROWER
Title or Position: DIRECTOR/OFFICER
Credential:
Phone: 406-854-2828