Healthcare Provider Details

I. General information

NPI: 1588726780
Provider Name (Legal Business Name): THOMPSON FALLS AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 HWY 200
THOMPSON FALLS MT
59873
US

IV. Provider business mailing address

PO BOX 1055
THOMPSON FALLS MT
59873-1055
US

V. Phone/Fax

Practice location:
  • Phone: 406-827-4536
  • Fax: 406-827-4536
Mailing address:
  • Phone: 406-827-4536
  • Fax: 406-827-4536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. MARCIE TOMAS
Title or Position: OFFICE MANAGER - BILLING CLERK
Credential:
Phone: 406-827-3446