Provider Demographics
NPI:1639399819
Name:DUTTON EMERGENCY MEDICAL SERVICES & TRAINING CENTER INC.
Entity Type:Organization
Organization Name:DUTTON EMERGENCY MEDICAL SERVICES & TRAINING CENTER INC.
Other - Org Name:DUTTON EMS
Other - Org Type:Other Name
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:DUNNING
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B
Authorized Official - Phone:406-476-3318
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:DUTTON
Mailing Address - State:MT
Mailing Address - Zip Code:59433-0012
Mailing Address - Country:US
Mailing Address - Phone:406-788-1122
Mailing Address - Fax:406-476-3318
Practice Address - Street 1:17 MAIN AVE WEST
Practice Address - Street 2:
Practice Address - City:DUTTON
Practice Address - State:MT
Practice Address - Zip Code:59433
Practice Address - Country:US
Practice Address - Phone:406-788-1122
Practice Address - Fax:406-476-3318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0442085Medicaid