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General NPI Number Information
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NPI Number | 1619748084
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Entity Type | Organization
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Legal Business Name | RAND W DICKSON INTERSTATE MEDICAL TRANSPORT
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 600 MAIN ST
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City | DEER LODGE
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State | MT
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Zip | 59722-1440
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Country | US
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Telephone | 406-691-9304
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2458
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City | EUREKA
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State | MT
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Zip | 59917-2458
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Country | US
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Telephone | 406-297-1627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAND DICKSON
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Credential |
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Telephone | 406-740-2646
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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 |
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License Number State |
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