NPI: 1205875978 · LAKESIDE, MT 59922 · Land Ambulance · NPI assigned 06/06/2006
| Authorized Official | OWEN, JORDAN (EXECUTIVE DIRECTOR) |
| NPI Enumeration Date | 06/06/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 30 | $821.79 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A0425 | Ground mileage, per statute mile | 30 | 25 | $821.79 |