Provider Demographics
NPI:1164557880
Name:CITY OF LIVINGSTON
Entity Type:Organization
Organization Name:CITY OF LIVINGSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-823-6002
Mailing Address - Street 1:414 E CALLENDER ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-2746
Mailing Address - Country:US
Mailing Address - Phone:406-823-6002
Mailing Address - Fax:406-222-6823
Practice Address - Street 1:414 E CALLENDER ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-2746
Practice Address - Country:US
Practice Address - Phone:406-823-6002
Practice Address - Fax:406-222-6823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT33341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0442598Medicaid
MT065212OtherBCBS
MT0442598Medicaid