1972625275 NPI number — BIG SKY FIRE DEPARTMENT

Table of content: (NPI 1972625275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972625275 NPI number — BIG SKY FIRE DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIG SKY FIRE DEPARTMENT
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:
6
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:
1972625275
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160382
Provider Second Line Business Mailing Address:
650 RAINBOW TROUT RUN
Provider Business Mailing Address City Name:
BIG SKY
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59716-0382
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-995-2100
Provider Business Mailing Address Fax Number:
406-995-2104

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
650 RAINBOW TROUT RUN (STATION 1)
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIG SKY
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-995-2100
Provider Business Practice Location Address Fax Number:
406-995-2104
Provider Enumeration Date:
04/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FISCHER
Authorized Official First Name:
ALECIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATIVE OFFICER
Authorized Official Telephone Number:
406-995-2100

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 65432 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: M000002379 . This is a "MEDICARE PART B" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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