Provider Demographics
NPI:1255461653
Name:COUNTY OF WHEATLAND
Entity type:Organization
Organization Name:COUNTY OF WHEATLAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHUCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-632-4892
Mailing Address - Street 1:201 A AVE NW
Mailing Address - Street 2:PO BOX 6930
Mailing Address - City:HARLOWTON
Mailing Address - State:MT
Mailing Address - Zip Code:59036-6930
Mailing Address - Country:US
Mailing Address - Phone:406-632-4892
Mailing Address - Fax:406-632-6018
Practice Address - Street 1:201 A AVE NW
Practice Address - Street 2:
Practice Address - City:HARLOWTON
Practice Address - State:MT
Practice Address - Zip Code:59036-6930
Practice Address - Country:US
Practice Address - Phone:406-632-4892
Practice Address - Fax:406-632-6018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT163416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000440492Medicaid
MT0000440492Medicaid