Provider Demographics
NPI:1750593901
Name:ROY AMBULANCE SERVICE INC
Entity type:Organization
Organization Name:ROY AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ROY AMBULANCE SERVICE INC
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BRYNE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT FRA
Authorized Official - Phone:406-464-2161
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:MT
Mailing Address - Zip Code:59471-0202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:MT
Practice Address - Zip Code:59471-0202
Practice Address - Country:US
Practice Address - Phone:406-464-2191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT341600000X
MT146341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance