# JESSE AMBULANCE SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broadus Truck & Supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952550535
- **Authorized official:** CINDY L. GRAFF (EMS DIRECTOR)
- **Authorized official phone:** (406) 436-2225

## Contact information

- **Practice address:** 201 EAST HOLT STREET, BROADUS, MT 59317-0000
- **Practice address phone:** (406) 436-2225
- **Practice address fax:** (406) 436-2033
- **Mailing address:** PO BOX 236, BROADUS, MT 59317-0236
- **Mailing address phone:** (406) 436-2225
- **Mailing address fax:** (406) 436-2033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 103 | MT | Yes |

## Other

- **Enumeration date:** 09/18/2008
- **Last updated:** 09/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000065042 | BLUE CROSS BLUE SHIELD OF MT | MT |
| 05 | — | 446654 | — | MT |