Healthcare Provider Details

I. General information

NPI: 1962544221
Provider Name (Legal Business Name): HULETT EMERGENCY MEDICAL SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 HILL STREET
HULETT WY
82720
US

IV. Provider business mailing address

PO BOX 294
HULETT WY
82720-0294
US

V. Phone/Fax

Practice location:
  • Phone: 307-290-4103
  • Fax: 605-443-8880
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number39
License Number StateWY

VIII. Authorized Official

Name: MRS. JEANETTE RAE PERRY
Title or Position: TREASURE
Credential:
Phone: 307-290-4103