Provider Demographics
NPI:1629036322
Name:PARMA RURAL FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:PARMA RURAL FIRE PROTECTION DISTRICT
Other - Org Name:PARMA AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:UNGARETTI
Authorized Official - Suffix:
Authorized Official - Credentials:CCEMTP
Authorized Official - Phone:406-549-7104
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:ID
Mailing Address - Zip Code:83660-0429
Mailing Address - Country:US
Mailing Address - Phone:208-722-5716
Mailing Address - Fax:
Practice Address - Street 1:29200 HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:ID
Practice Address - Zip Code:83660
Practice Address - Country:US
Practice Address - Phone:208-250-5041
Practice Address - Fax:208-722-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID73033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDE0427OtherIDAHO BC/BS
ID002806600Medicaid
ID10014289OtherREGENCE BC/BS
OR298980Medicaid
ID1501087Medicare ID - Type Unspecified
OR298980Medicaid