Provider Demographics
NPI:1881633543
Name:BIG MOUNTAIN FIRE DISTRICT
Entity Type:Organization
Organization Name:BIG MOUNTAIN FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
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:406-862-3748
Mailing Address - Street 1:PO BOX 7374
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59904-7374
Mailing Address - Country:US
Mailing Address - Phone:406-253-7240
Mailing Address - Fax:
Practice Address - Street 1:3790 BIG MOUNTAIN RD.
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937
Practice Address - Country:US
Practice Address - Phone:406-862-3748
Practice Address - Fax:406-862-8554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1543416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0441949Medicaid
MT65642OtherBCBS
MT0441949Medicaid
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