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General NPI Number Information
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NPI Number | 1942347844
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Entity Type | Organization
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Legal Business Name | SWEETWATER MEDICS LLC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 12/09/2013
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Provider Practice Location Address
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Address Line | 916 PILOT BUTTE AVE
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5349
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Country | US
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Telephone | 307-362-6108
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Fax | 307-362-6165
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Provider Business Mailing Address
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Address Line | PO BOX 356
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City | ROCK SPRINGS
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State | WY
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Zip | 82902-0356
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Country | US
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Telephone | 307-362-6108
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Fax | 307-362-6165
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Authorized Official
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Title or Position | DIRECTOR
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Name | RONALD G GATTI
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Credential |
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Telephone | 307-371-8833
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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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