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General NPI Number Information
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NPI Number | 1073706321
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Entity Type | Organization
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Legal Business Name | REDWATER VALLEY AMBULANCE SERVICE
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 606 SULLIVAN AVE
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City | CIRCLE
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State | MT
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Zip | 59215-0567
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Country | US
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Telephone | 406-485-2313
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 567
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City | CIRCLE
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State | MT
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Zip | 59215-0567
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Country | US
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Telephone | 406-485-2313
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Fax |
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Authorized Official
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Title or Position | ACCOUNTANT
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Name | CANDY MILROY
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Credential |
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Telephone | 406-460-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 3416L0300X
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License Number State | MT
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