Beaverhead Emergency Medical Services
Organization Active NPI Ambulance · Dillon, MT
NPI 1154478618 · NPPES record last updated Jun 29, 2016
Key facts
- NPI
- 1154478618
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 104 (MT)
- Legal business name
- BEAVERHEAD EMERGENCY MEDICAL SERVICES
- Practice address
- 330 E Reeder St
Dillon, MT 59725-2777 - Phone
- (406) 683-2833
- Fax
- (406) 683-2833
- NPI assigned
- Jan 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Jean Bergeson, J.D.
- Title
- Billing Manager
- Phone
- (406) 683-2391
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040127001207 | MT | Part B Supplier - Ambulance Service Supplier | 9234032319 | Practice locations: Dillon, MT |
National Provider Directory
Locations
301 S Atlantic St
Dillon, MT 59725
Phone (406) 683-5874
330 E Reeder St
Dillon, MT 59725
Phone (406) 683-2391
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 104 | MT | Yes |
Addresses
Primary practice location
330 E Reeder St
Dillon, MT 59725-2777
Mailing address
P.O. Box 1106
Dillon, MT 59725-1106
Phone (406) 683-2833
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 443352 | Medicaid | MT | |
| M000002338 | Other | MT | MEDICARE ID - TYPE UNSPECIFIED |
Other names
- Beaverhead EMS
Other providers in Dillon, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2016. 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.