Provider Demographics
NPI:1609994524
Name:COUNTY OF RICH
Entity Type:Organization
Organization Name:COUNTY OF RICH
Other - Org Name:RICH COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-793-2415
Mailing Address - Street 1:80 NORTH 300 WEST
Mailing Address - Street 2:PO BOX 126
Mailing Address - City:TROPIC
Mailing Address - State:UT
Mailing Address - Zip Code:84776
Mailing Address - Country:US
Mailing Address - Phone:435-679-8710
Mailing Address - Fax:
Practice Address - Street 1:20 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:UT
Practice Address - Zip Code:84064
Practice Address - Country:US
Practice Address - Phone:435-793-2415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1701L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========004Medicaid