Memorial Ambulance of Fort Benton Montana

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

14 Issued in MT

Legal business name

MEMORIAL AMBULANCE OF FORT BENTON MONTANA

Practice address

810 15TH St
Fort Benton, MT 59442-8993

Phone

(406) 622-3400

Fax

(406) 622-4255

NPI assigned

May 2, 2006

Organization subpart

No

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

Authorized official

Name

Amber L Hurt, NREMTP

Title

Service Manager

Phone

(406) 301-4288

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Memorial Ambulance Service Other name

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

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1932167640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2458",
            "city": "EUREKA",
            "state": "MT",
            "postal_code": "599172458",
            "telephone_number": "406-297-1627",
            "fax_number": "855-574-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 15TH ST",
            "city": "FORT BENTON",
            "state": "MT",
            "postal_code": "594428993",
            "telephone_number": "406-622-3400",
            "fax_number": "406-622-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL AMBULANCE OF FORT BENTON MONTANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "HURT",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SERVICE MANAGER",
        "authorized_official_telephone_number": "406-301-4288",
        "authorized_official_credential": "NREMTP"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MT",
            "license": "14",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445068",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1352",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Ambulance Service",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Memorial Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Angelica M. Johnson, F.N.P.
• Krystal Ann Joyce, D.P.T.
• Robert J. Labrel, DDS
• Danielle Maestas, PA-C
• Chase Alexander McGlinchey, PA
• Montana Therapy
• Dawn M Nelson, P.T.
• Craig Raymond Nicholson, M.D.
• Pawsitive Healing Counseling
• Carol Georgeanne Richard

• Land Ambulance in Fort Benton, MT
• Providers in Fort Benton, MT by specialty
• Land Ambulance in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.