Organization
PARK CITY AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MYRON GROSS (BOARD DIRECTOR)
(406) 633-9898
Entity
Organization
Contact information
Practice address
102 1ST AVE SW, PARK CITY, MT 59063
(406) 633-2345
(406) 633-2015
Mailing address
PO BOX 292, PARK CITY, MT 59063
(406) 549-7104
(406) 542-2785
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
105
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446511
—
MT
01
—
65102
BCBS
MT
Enumeration date
05/02/2006
Last updated
10/24/2018
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