| Organization Name: | CONVERSE COUNTY AMBULANCE |
| NPI Number: | 1033263447 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREA L JOHNSON (BILLING CLERK) |
| Mailing Address: | 107 N 5th St Suite 114 Douglas |
| State: | WY US |
| Postal Code: | 826332423 |
| Phone Number: | 3073582244 |
| Fax Number: | 3073585998 |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |