Provider Demographics
NPI:1225106511
Name:MARION AMBULANCE & RESCUE SERVICE INC
Entity Type:Organization
Organization Name:MARION AMBULANCE & RESCUE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:TROUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-854-2894
Mailing Address - Street 1:PO BOX 933
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MT
Mailing Address - Zip Code:59925-0933
Mailing Address - Country:US
Mailing Address - Phone:406-854-2894
Mailing Address - Fax:
Practice Address - Street 1:660 GOPHER LN
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MT
Practice Address - Zip Code:59925-9789
Practice Address - Country:US
Practice Address - Phone:406-854-2894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-03
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0273416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT442637Medicaid