Provider Demographics
NPI:1316582315
Name:POWELL EMERGENCY MEDICAL SERVICE
Entity Type:Organization
Organization Name:POWELL EMERGENCY MEDICAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SPRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-415-1034
Mailing Address - Street 1:1100 HOLLENBECK LN
Mailing Address - Street 2:
Mailing Address - City:DEER LODGE
Mailing Address - State:MT
Mailing Address - Zip Code:59722-2317
Mailing Address - Country:US
Mailing Address - Phone:406-415-1034
Mailing Address - Fax:406-846-2789
Practice Address - Street 1:1100 HOLLENBECK LN
Practice Address - Street 2:
Practice Address - City:DEER LODGE
Practice Address - State:MT
Practice Address - Zip Code:59722-2317
Practice Address - Country:US
Practice Address - Phone:406-415-1034
Practice Address - Fax:406-846-2789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport