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General NPI Number Information
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NPI Number | 1699714352
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Entity Type | Organization
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Legal Business Name | PHILLIPS COUNTY
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 314 S 2ND W
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City | MALTA
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State | MT
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Zip | 59538
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Country | US
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Telephone | 406-654-2336
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Fax | 406-654-2940
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Provider Business Mailing Address
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Address Line | PO BOX 289
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City | MALTA
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State | MT
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Zip | 59538-0289
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Country | US
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Telephone | 406-654-2336
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Fax | 406-654-2940
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Authorized Official
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Title or Position | BOARD MEMBER / NREMT
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Name | RILEY SAMUEL JOHN ABRAHAMSON
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Credential | NREMT
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Telephone | 406-654-2336
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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 | 058
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License Number State | MT
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