Organization
CITY OF GLENDIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN DORWART (AMBULANCE DIRECTOR)
(406) 377-3318
Entity
Organization
Contact information
Practice address
300 S MERRILL AVE, GLENDIVE, MT 59330-1610
(406) 377-3318
(406) 377-6873
Mailing address
300 S MERRILL AVE, GLENDIVE, MT 59330-1610
(406) 377-3318
(406) 377-6873
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
48
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001292
BCBS
MT
05
—
0445575
—
MT
Enumeration date
02/22/2007
Last updated
11/13/2009
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