Organization
LIBBY VOLUNTEER AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY DEAN KYES (SECRETARY)
(406) 293-5582
Entity
Organization
Contact information
Practice address
307 MONTANA AVE, LIBBY, MT 59923-2037
(406) 293-5582
(406) 293-6868
Mailing address
307 MONTANA AVE, LIBBY, MT 59923-2037
(406) 293-5582
(406) 293-6868
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
021
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001222
BLUE CROSS PIN
MT
05
—
0448383
—
MT
01
—
184596400
OFFICE OF WORK COMP US
MT
01
—
590009369
RAILROAD MEDICARE
MT
Enumeration date
11/02/2006
Last updated
03/04/2013
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