Provider Demographics
NPI:1780974154
Name:FIELDING TOWN
Entity type:Organization
Organization Name:FIELDING TOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:L
Authorized Official - Last Name:EARL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-458-3682
Mailing Address - Street 1:150 S 100 W
Mailing Address - Street 2:PO BOX 68
Mailing Address - City:FIELDING
Mailing Address - State:UT
Mailing Address - Zip Code:84311
Mailing Address - Country:US
Mailing Address - Phone:435-458-3682
Mailing Address - Fax:435-458-3682
Practice Address - Street 1:150 S 100 W
Practice Address - Street 2:
Practice Address - City:FIELDING
Practice Address - State:UT
Practice Address - Zip Code:84311
Practice Address - Country:US
Practice Address - Phone:435-458-3682
Practice Address - Fax:435-458-3682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT0260L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport