City of Havre

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

017 Issued in MT

Legal business name

CITY OF HAVRE

Doing business as

Havre Ambulance Service

Practice address

520 4TH St
Havre, MT 59501-3650

Phone

(406) 268-5651

Fax

(406) 265-5088

NPI assigned

Jul 29, 2005

Last updated

Jul 24, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Eric Sheppard

Title

Fire Chief

Phone

(406) 265-6511

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Havre Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1184624264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 4TH ST",
            "city": "HAVRE",
            "state": "MT",
            "postal_code": "595013650",
            "telephone_number": "406-268-5651",
            "fax_number": "406-265-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 4TH ST",
            "city": "HAVRE",
            "state": "MT",
            "postal_code": "595013650",
            "telephone_number": "406-268-5651",
            "fax_number": "406-265-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF HAVRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "406-265-6511"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MT",
            "license": "017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "6516 2",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044-8162",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Havre Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Havre, MT
• Providers in Havre, MT by specialty
• Land Ambulance in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.