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Organization

MEDICAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PEGGY L METIVIER (MANAGER)
(406) 327-1510
Entity
Organization

Contact information

Practice address
3301 PARK ST, MISSOULA, MT 59801-8762
(406) 327-1510
(406) 829-0482
Mailing address
PO BOX 1597, MISSOULA, MT 59806-1597
(406) 327-1510
(406) 829-0482

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
9199
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
520421
MT
05
540413
MT
Enumeration date
02/04/2007
Last updated
08/22/2020
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