Provider Demographics
NPI:1831107242
Name:HOT SPRINGS COMMUNITY AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:HOT SPRINGS COMMUNITY AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JETTA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ALDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-741-2211
Mailing Address - Street 1:PO BOX 830
Mailing Address - Street 2:106 S. ARLEE
Mailing Address - City:HOT SPRINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59845-0830
Mailing Address - Country:US
Mailing Address - Phone:406-741-2211
Mailing Address - Fax:406-741-2210
Practice Address - Street 1:106 S. ARLEE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:MT
Practice Address - Zip Code:59845-0830
Practice Address - Country:US
Practice Address - Phone:406-741-2211
Practice Address - Fax:406-741-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0723416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT6513-2OtherBLUE CROSS/BLUE SHIELD
MT0000443612Medicaid