# THREE FORKS AREA AMBULANCE SERVICE DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164404026
- **Authorized official:** MR. WILLIAM FRANK (CHAIRMAN OF THE BOARD OF DIRECTORS)
- **Authorized official phone:** (406) 285-3671

## Contact information

- **Practice address:** 15 EAST DATE STREET, THREE FORKS, MT 59752-0911
- **Practice address phone:** (406) 285-3819
- **Practice address fax:** (406) 285-3819
- **Mailing address:** PO BOX 911, 15 E. DATE ST., THREE FORKS, MT 59752-0911
- **Mailing address phone:** (406) 285-3819
- **Mailing address fax:** (406) 285-3819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 140 | MT | Yes |

## Other

- **Enumeration date:** 11/16/2005
- **Last updated:** 11/07/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 442273 | — | MT |
| 01 | — | 590006915 | RAILROAD MEDICARE | MT |
| 01 | — | 810472614 597520000 | TRICARE | MT |