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General NPI Number Information
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NPI Number | 1487868063
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Entity Type | Organization
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Legal Business Name | LINCOLN VOLUNTEER AMBULANCE SERVICE CORPORATION
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 114 STEMPLE PASS ROAD #455
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City | LINCOLN
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State | MT
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Zip | 59639-0455
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Country | US
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Telephone | 406-362-4313
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Fax |
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Provider Business Mailing Address
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Address Line | STEMPLE PASS ROAD PO BOX 455
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City | LINCOLN
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State | MT
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Zip | 59639-0455
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Country | US
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Telephone | 406-362-4313
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MS. LAURAN MARIE NICOLAI
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Credential |
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Telephone | 406-362-4313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 75
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License Number State | MT
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