City of Boulder
Organization Active NPI Land Ambulance · Boulder, MT
NPI 1376696500 · NPPES record last updated Jul 2, 2008
Key facts
- NPI
- 1376696500
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 005 (MT)
- Legal business name
- CITY OF BOULDER
- Practice address
- 205 W Second Ave
Ambulance Barn
Boulder, MT 59632-0068 - Phone
- (406) 225-3381
- Fax
- (406) 225-9498
- NPI assigned
- Jan 19, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- CITY OF BOULDER
Authorized official
- Name
- Mr. Daryl Craft
- Title
- Mayor City of Boulder
- Phone
- (406) 228-3381
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040205000542 | MT | Part B Supplier - Ambulance Service Supplier | 9436042249 | Practice locations: Boulder, MT |
National Provider Directory
- Part of
- City of Boulder
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 005 | MT | Yes |
Addresses
Primary practice location
205 W Second Ave
Ambulance Barn
Boulder, MT 59632-0068
Mailing address
PO Box 68
Boulder, MT 59632-0068
Phone (406) 225-3381
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 448864 | Medicaid | MT |
Other providers in Boulder, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2008. 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.