MEDICARE: LOGAN HEALTH EMERGENCY MEDICAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance
2	341600000X	Ambulance

General Provider Information

NPI Number	:	1386389856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOGAN HEALTH EMERGENCY MEDICAL SERVICES

Provider Business Mailing Address
First Line	:	330 CONWAY DRIVE
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901
Country	:	US
Telephone Number	:	406-858-6813
Fax Number	:	406-858-6814

Provider Business Practice Location Address
First Line	:	330 CONWAY DRIVE
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901
Country	:	US
Telephone Number	:	406-858-6813
Fax Number	:	406-858-6814

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	CLINTON SEGER
Credential	:	MD
Telephone Number	:	406-752-1724

Provider Enumeration Date	:	04/29/2022
Last Update Date	:	03/24/2026

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