Healthcare Provider Details

I. General information

NPI: 1497781843
Provider Name (Legal Business Name): MONTANA MEDICAL TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 AIRPORT RD STE 2
HELENA MT
59601-1234
US

IV. Provider business mailing address

2430 AIRPORT RD STE 2
HELENA MT
59601-1234
US

V. Phone/Fax

Practice location:
  • Phone: 406-442-2190
  • Fax: 406-442-2199
Mailing address:
  • Phone: 406-442-2190
  • Fax: 406-442-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number174
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number807
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JOHN J MAXNESS
Title or Position: MEMBER
Credential:
Phone: 406-442-2190