Provider Demographics
NPI:1508322256
Name:CLARKSTON FIRE SERVICE AREA #6
Entity Type:Organization
Organization Name:CLARKSTON FIRE SERVICE AREA #6
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEANE
Authorized Official - Suffix:
Authorized Official - Credentials:AEMT
Authorized Official - Phone:406-285-4661
Mailing Address - Street 1:PO BOX 2458
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-2458
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12455 CLARKSTON RD
Practice Address - Street 2:
Practice Address - City:THREE FORKS
Practice Address - State:MT
Practice Address - Zip Code:59752-9734
Practice Address - Country:US
Practice Address - Phone:406-285-4661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport