Provider Demographics
NPI:1598939282
Name:LIBERTY COUNTY
Entity Type:Organization
Organization Name:LIBERTY COUNTY
Other - Org Name:LIBERTY COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-292-3638
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MT
Mailing Address - Zip Code:59522-0459
Mailing Address - Country:US
Mailing Address - Phone:406-759-5743
Mailing Address - Fax:
Practice Address - Street 1:710 W MONROE AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MT
Practice Address - Zip Code:59522-0459
Practice Address - Country:US
Practice Address - Phone:406-759-5743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport