Provider Demographics
NPI:1609932698
Name:DENTON AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:DENTON AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-567-0054
Mailing Address - Street 1:3208 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8793
Mailing Address - Country:US
Mailing Address - Phone:406-586-2096
Mailing Address - Fax:
Practice Address - Street 1:401 MAIN STREET
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MT
Practice Address - Zip Code:59430-0446
Practice Address - Country:US
Practice Address - Phone:406-567-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT443416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1462OtherBLUECROSS BLUESHIELD
MTP00329960OtherRAILROAD CARRIER
MTP00329960OtherRAILROAD CARRIER