Provider Demographics
NPI:1467505941
Name:TOWN OF WHITEHALL
Entity Type:Organization
Organization Name:TOWN OF WHITEHALL
Other - Org Name:WHITEHALL AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SERVICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:GIONO
Authorized Official - Last Name:JANIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-287-3972
Mailing Address - Street 1:PO BOX 529
Mailing Address - Street 2:2 NORTH WHITEHALL STREET
Mailing Address - City:WHITEHALL
Mailing Address - State:MT
Mailing Address - Zip Code:59759-0529
Mailing Address - Country:US
Mailing Address - Phone:406-287-3972
Mailing Address - Fax:406-287-5088
Practice Address - Street 1:2 NORTH WHITEHALL STREET
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MT
Practice Address - Zip Code:59759-0529
Practice Address - Country:US
Practice Address - Phone:406-287-3972
Practice Address - Fax:406-287-5088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT353416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT448422Medicaid
MT2337Medicare ID - Type Unspecified