Healthcare Provider Details

I. General information

NPI: 1053722678
Provider Name (Legal Business Name): RED LODGE RURAL FIRE DISTRICT 7
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N BROADWAY AVE.
RED LODGE MT
59068-0318
US

IV. Provider business mailing address

PO BOX 318 801 N BROADWAY AVE
RED LODGE MT
59068-0318
US

V. Phone/Fax

Practice location:
  • Phone: 406-446-2320
  • Fax: 406-446-9828
Mailing address:
  • Phone: 406-446-2320
  • Fax: 406-446-9828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number725
License Number StateMT

VIII. Authorized Official

Name: THOMAS KUNTZ
Title or Position: FIRE CHIEF
Credential:
Phone: 406-855-6198