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General NPI Number Information
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NPI Number | 1629171723
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Entity Type | Organization
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Legal Business Name | TROY VOLUNTEER AMBULANCE
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 210 N THIRD ST
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City | TROY
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State | MT
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Zip | 59935-0641
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Country | US
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Telephone | 406-295-6505
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Fax | 406-295-6510
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Provider Business Mailing Address
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Address Line | PO BOX 641
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City | TROY
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State | MT
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Zip | 59935-0641
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Country | US
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Telephone | 406-295-6505
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Fax | 406-295-6510
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Authorized Official
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Title or Position | OFFICER MANAGER
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Name | ROGER GILLIGAN
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Credential |
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Telephone | 406-295-6505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 066A1S
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License Number State | MT
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