Provider Demographics
NPI:1730839036
Name:LOON LAKE FIRE & RESCUE CO., LLC
Entity type:Organization
Organization Name:LOON LAKE FIRE & RESCUE CO., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:EMTB E3501701
Authorized Official - Phone:406-334-4005
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:TREGO
Mailing Address - State:MT
Mailing Address - Zip Code:59934-0550
Mailing Address - Country:US
Mailing Address - Phone:406-334-4005
Mailing Address - Fax:
Practice Address - Street 1:1911 LOON LAKE RD
Practice Address - Street 2:
Practice Address - City:TREGO
Practice Address - State:MT
Practice Address - Zip Code:59934-7798
Practice Address - Country:US
Practice Address - Phone:406-334-4005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport