POWELL COUNTY AMBULANCE SERVICE INC (NPI# 1700825478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700825478 |
| Entity Type | Organization |
| Organization Name | POWELL COUNTY AMBULANCE SERVICE INC |
| Practice Address |
1101 Texas Ave Deer Lodge MT 59722 |
| Mailing Address |
Po Box 1359 1243 Burlington Ave Missoula MT 59806-1359 |
| Practice Telephone | 4068462212 |
| Practice Fax Number | 4068466039 |
| Mailing Telephone | 4065497104 |
| Mailing Fax Number | 4065422785 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2013-05-24 |
| Authorized Official Name | JOHN R UNGARETTI (GENERAL MANAGER) |
| Authorized Official Telephone | 4065497104 |
| Authorized Official Credential | CCEMTP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
043 | MT | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0000445510 | 05 | |
| MT | BC/BS | 00124-2 | 01 |
| ID | 80708400 | 05 |
| Street Address |
1101 TEXAS AVE |
| City | DEER LODGE |
| State | MT |
| Zip Code | 59722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942515762 | Thomas G. Rachie | Chiropractor | 1101 Texas Ave, Deer Lodge, MT 59722-1828 | 2010-08-17 |
| 1407013261 | Providence Health & Services Mt | Internal Medicine | 1101 Texas Ave, Deer Lodge, MT 59722-1828 | 2008-05-20 |
| 1629121082 | James Barry Oser | Family Medicine | 1101 Texas Ave, Deer Lodge, MT 59722-1828 | 2007-01-19 |
| 1396898755 | Barb H Bailey | Physician Assistant | 1101 Texas Ave, Deer Lodge, MT 59722-1828 | 2007-01-19 |
| 1508880527 | Leonard Joseph Bauer | Family Medicine | 1101 Texas Ave, Deer Lodge, MT 59722-1828 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891083937 | Summera Qamar | Family Medicine | 1100 Hollenback Ln., Deer Lodge, MT 59722 | 2011-07-11 |
| 1164453932 | Judith H Wilson | Legal Medicine | 1100 Hollenback Ln, Deer Lodge, MT 59722 | 2006-07-06 |
| 1891159877 | Powell County Memorial Hospital Association Inc | General Acute Care Hospital | 1100 Hollenback Ln., Deer Lodge, MT 59722 | 2016-04-06 |
| 1891916318 | Kimberly J Stavlo | Speech-Language Pathologist | 310 Main Street, Deer Lodge, MT 59722 | 2007-05-01 |
| 1750393757 | Lori Lee Drumm | Family Medicine | 1100 Hollenback Ln, Deer Lodge, MT 59722 | 2006-08-12 |
| 1306262803 | Cottonwood Clinic, LLC | Nurse Practitioner | 310 Main St, Deer Lodge, MT 59722-1000 | 2014-03-10 |
| 1750600375 | Deer Lodge Valley Therapy | Clinic/Center | 310 Main St, Deer Lodge, MT 59722-1000 | 2010-05-21 |
| 1043337140 | Heide Lynn Applegate | Nurse Practitioner | 310 Main St, Deer Lodge, MT 59722-1000 | 2007-03-23 |
| 1477596161 | Debra Joan Miller | Nurse Practitioner | 310 Main St, Deer Lodge, MT 59722-1000 | 2006-06-13 |
| 1477734416 | Powell County Health Department | Clinic/Center | 304 Milwaukee Ave Ste 23, Deer Lodge, MT 59722-1035 | 2007-11-19 |
| Find all providers in zip 59722 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316582315 | Powell Emergency Medical Service | Ambulance | 1100 Hollenbeck Ln, Deer Lodge, MT 59722-2317 | 2019-11-13 |
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|---|---|---|---|---|
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| 1235610361 | Town of Stevensville | Ambulance | 206 Buck St, Stevensville, MT 59870-2021 | 2018-08-27 |
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| 1144687138 | Marion Fire District | Ambulance | 180 Gopher Ln, Marion, MT 59925 | 2016-01-21 |
| 1902282239 | Bridger Emergency Training Center LLC | Ambulance | 2110 Harnish Blvd Ste 1, Billings, MT 59101 | 2015-08-10 |
| 1447650148 | Absarokee Ambulance Service | Ambulance | 105 W. B St., Absarokee, MT 59001 | 2014-08-29 |
| 1053722678 | Red Lodge Rural Fire District 7 | Ambulance | 801 N Broadway Ave., Red Lodge, MT 59068-0318 | 2014-05-16 |
| Find all providers with the same taxonomy | ||||
| City | DEER LODGE |
| Zip Code | 59722 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.