Provider Demographics
NPI:1689720716
Name:COUNTY OF PIUTE
Entity Type:Organization
Organization Name:COUNTY OF PIUTE
Other - Org Name:PIUTE COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-326-4558
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:84776-0126
Mailing Address - Country:US
Mailing Address - Phone:435-679-8710
Mailing Address - Fax:435-679-8711
Practice Address - Street 1:550 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:JUNCTION
Practice Address - State:UT
Practice Address - Zip Code:84740
Practice Address - Country:US
Practice Address - Phone:435-326-4558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT0601L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========006Medicaid
UT000009320Medicare ID - Type Unspecified