Provider Demographics
NPI:1790928695
Name:GREAT FALLS EMERGENCY SERVICES
Entity Type:Organization
Organization Name:GREAT FALLS EMERGENCY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GERNERAL MANAGER
Authorized Official - Prefix:MR
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 1:1008 BURLINGTON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-5682
Mailing Address - Country:US
Mailing Address - Phone:406-549-7104
Mailing Address - Fax:406-548-2785
Practice Address - Street 1:514 9TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4038
Practice Address - Country:US
Practice Address - Phone:406-549-7104
Practice Address - Fax:406-542-2785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTP.S. C. NO. 9470343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)