1245385814 NPI number — COUNTY OF EMERY

Table of content: (NPI 1245385814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245385814 NPI number — COUNTY OF EMERY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF EMERY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EMERY COUNTY AMBULANCE SERVICE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245385814
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 907
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CASTLE DALE
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84513-0907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-381-5106
Provider Business Mailing Address Fax Number:
435-381-5183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 E MAIN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CASTLE DALE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-381-2200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TUTTLE
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
Authorized Official Title or Position:
COUNTY CLERK
Authorized Official Telephone Number:
435-381-5106

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0801L , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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