LAKESIDE QRU INC NPI 1205875978

NPI Information

NPI: 1205875978
Provider Name: LAKESIDE QRU, INC

Other Name: UPPER WEST SHORE QUICK RESPONSE UNIT

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
201 BILLS RD
LAKESIDE, MT
ZIP 59922
Phone: (406) 844-2775
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LAKESIDE QRU, INC is a land transport ambulance in Lakeside, MT. LAKESIDE QRU, INC NPI is 1205875978. The provider is registered as an organization entity type.
The provider Other Name Is Upper West Shore Quick Response Unit.

The provider's business location address is:

201 BILLS RD
LAKESIDE, MT
ZIP 59922
Phone: (406) 844-2775
Fax: (406) 844-3663

The provider's authorized official is Jordan Owen .
The authorized official title is Executive Director and has the following contact phone number (406) 844-2775.

The CLIA number assigned to this NPI record is 27D2103044 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/6/2006 and was last updated on 5/19/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	152	MONTANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0442238	MEDICAID	MONTANA
2	65762	OTHER	MONTANA	BLUE CROSS BLUE SHIELD
3	657682	OTHER	MONTANA	BC BS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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