1922145473 NPI number — NORTH VALLEY EMERGENCY MEDICAL SERVICES INC

Table of content: (NPI 1922145473)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922145473 NPI number — NORTH VALLEY EMERGENCY MEDICAL SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH VALLEY EMERGENCY MEDICAL SERVICES INC
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:
Provider Other Organization Name Type Code:
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:
1922145473
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1359
Provider Second Line Business Mailing Address:
1243 BURLINGTON AVE
Provider Business Mailing Address City Name:
MISSOULA
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59806-1359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-850-4574
Provider Business Mailing Address Fax Number:
406-524-2785

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 MAIN STREET
Provider Second Line Business Practice Location Address:
142
Provider Business Practice Location Address City Name:
OPHEIM
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59250-0142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-724-3484
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ST. JOHN
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
406-762-3430

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  062 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 62 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 590005487 . This is a "RAILROAD MEDIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0440895 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0440946 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001892 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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