Provider Demographics
NPI:1619446481
Name:COUNTY OF MOFFAT
Entity Type:Organization
Organization Name:COUNTY OF MOFFAT
Other - Org Name:MOFFAT COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN, BOARD OF COUNTY COMMISSIO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-824-9112
Mailing Address - Street 1:221 W VICTORY WAY STE 115
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2732
Mailing Address - Country:US
Mailing Address - Phone:970-824-9125
Mailing Address - Fax:970-824-9191
Practice Address - Street 1:221 W. VICTORY WAY
Practice Address - Street 2:SUITE 130
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625
Practice Address - Country:US
Practice Address - Phone:970-824-9153
Practice Address - Fax:970-824-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Multi-Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty