Provider Demographics
NPI:1609916071
Name:WILLSON LLC DBA CITY CAB
Entity Type:Organization
Organization Name:WILLSON LLC DBA CITY CAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-254-2900
Mailing Address - Street 1:PO BOX 2333
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59103-2333
Mailing Address - Country:US
Mailing Address - Phone:406-254-2900
Mailing Address - Fax:406-254-1805
Practice Address - Street 1:314 N 20TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1403
Practice Address - Country:US
Practice Address - Phone:406-254-2900
Practice Address - Fax:406-254-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0033267Medicaid
MT0621826Medicaid