Healthcare Provider Details

I. General information

NPI: 1538289657
Provider Name (Legal Business Name): COUNTY OF GOLDEN VALLEY OFFICE OF CLERK & RECORDER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 KEMP STREET
RYEGATE MT
59074
US

IV. Provider business mailing address

PO BOX 55
RYEGATE MT
59074-0055
US

V. Phone/Fax

Practice location:
  • Phone: 406-568-2321
  • Fax: 406-568-2598
Mailing address:
  • Phone: 406-568-2321
  • Fax: 406-568-2598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateMT

VIII. Authorized Official

Name: LYLE BURGESS
Title or Position: DIRECTOR
Credential:
Phone: 406-568-2321