Healthcare Provider Details

I. General information

NPI: 1336087105
Provider Name (Legal Business Name): GLACIER RIDGE TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 CONTINENTAL DR
BUTTE MT
59701-6565
US

IV. Provider business mailing address

2500 CONTINENTAL DR
BUTTE MT
59701-6565
US

V. Phone/Fax

Practice location:
  • Phone: 406-564-4722
  • Fax:
Mailing address:
  • Phone: 406-564-4722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. RANDY EDWARDS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 406-564-4722