Provider Demographics
NPI:1326745951
Name:SAWTOOTH MOUNTAIN EMS
Entity Type:Organization
Organization Name:SAWTOOTH MOUNTAIN EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:NIESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-713-5830
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:HERON
Mailing Address - State:MT
Mailing Address - Zip Code:59844-0150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 LOWER RIVER RD
Practice Address - Street 2:
Practice Address - City:HERON
Practice Address - State:MT
Practice Address - Zip Code:59844-9549
Practice Address - Country:US
Practice Address - Phone:406-847-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport