# COUNTY OF GOLDEN VALLEY OFFICE OF CLERK & RECORDER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Golden Valley Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538289657
- **Authorized official:** LYLE BURGESS (DIRECTOR)
- **Authorized official phone:** (406) 568-2321

## Contact information

- **Practice address:** 107 KEMP STREET, RYEGATE, MT 59074
- **Practice address phone:** (406) 568-2321
- **Practice address fax:** (406) 568-2598
- **Mailing address:** PO BOX 55, RYEGATE, MT 59074-0055
- **Mailing address phone:** (406) 568-2321
- **Mailing address fax:** (406) 568-2598

## Taxonomy

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

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000020012 | BLUE CROSS | MT |
| 05 | — | 272833 | — | MT |
| 01 | — | 590014533 | RR MEDICARE | MT |