Hildale Town Corp
Organization Active NPI Land Ambulance · Hildale, UT
NPI 1982808705 · NPPES record last updated Mar 11, 2010
Key facts
- NPI
- 1982808705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 2720L (UT)
- Legal business name
- HILDALE TOWN CORP
- Practice address
- 900 North 350 East
Hildale, UT 84784-1588 - Phone
- (435) 874-2400
- Fax
- (435) 874-2753
- NPI assigned
- Jun 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Glen Jeffs
- Title
- Manager
- Phone
- (435) 874-2400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100310000206 | UT | Part B Supplier - Ambulance Service Supplier | 9234274697 | Practice locations: Hildale, UT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 2720L | UT | Yes |
Addresses
Primary practice location
900 North 350 East
Hildale, UT 84784-1588
Mailing address
PO Box 841588
Hildale, UT 84784-1588
Phone (435) 874-2400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 314568 | Medicaid | AZ |
Other names
- Hildale Fire Department
Other providers in Hildale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.