Provider Demographics
NPI:1508912940
Name:TREMONTON CITY
Entity Type:Organization
Organization Name:TREMONTON CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-257-9504
Mailing Address - Street 1:102 S TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:TREMONTON
Mailing Address - State:UT
Mailing Address - Zip Code:84337-1636
Mailing Address - Country:US
Mailing Address - Phone:435-257-9502
Mailing Address - Fax:435-257-9513
Practice Address - Street 1:102 S TREMONT ST
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337-1636
Practice Address - Country:US
Practice Address - Phone:435-257-9502
Practice Address - Fax:435-257-9513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT0202L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========002Medicaid
UT=========002Medicaid