Provider Demographics
NPI:1740245398
Name:WISDOM RURAL FIRE DEPARTMENT
Entity Type:Organization
Organization Name:WISDOM RURAL FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:STEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-689-3225
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:WISDOM
Mailing Address - State:MT
Mailing Address - Zip Code:59761-0032
Mailing Address - Country:US
Mailing Address - Phone:406-689-3240
Mailing Address - Fax:
Practice Address - Street 1:224 MAIN
Practice Address - Street 2:
Practice Address - City:WISDOM
Practice Address - State:MT
Practice Address - Zip Code:59761-0032
Practice Address - Country:US
Practice Address - Phone:406-689-3240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0443144Medicaid
MT1922OtherBLUE CROSS/BLUE SHIELD
MTM000002314Medicare PIN