CMS-1500 Box 24J / 33a • NPI
1154360816
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
3416L0300X (CMS 59)
Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance
Box 32 Service Location & ZIP+4
810 GRAND AVE, BIGFORK, MT, 59911-3531
✓ 9-Digit EDI 837 ZIP+4 (59911-3531)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1154360816 (BIG FORK FIRE AND AMBULANCE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1154360816 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BIG FORK FIRE AND AMBULANCE |
| Plain-English Specialty | Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance NUCC Code: 3416L0300X (Ambulance, Land Transport) |
| Certifying / Licensing Body | State EMS Authority / National Registry of Emergency Medical Technicians (NREMT) |
| Practice Location Address | 810 GRAND AVE, BIGFORK, MT, 59911-3531 |
| Practice Telephone / Fax | Tel: (406) 837-7402 | Fax: (406) 837-2521 |
| Administrative Mailing Address | 1008 BURLINGTON AVE STE C, MISSOULA, MT, 59806-1359 |
| Enumeration & Last Sync | Enumerated: 2006-06-06 | CMS Record Updated: 2020-08-22 |
| Authorized Official | JOHN UNGARETTI (General Manager) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (3416L0300X)
What Does Taxonomy Code 3416L0300X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3416L0300X translates to:
"Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BIG FORK FIRE AND AMBULANCE)
Typical CPT / Diagnostic Procedures:- Advanced Life Support (ALS) Pre-Hospital Cardiac Monitoring & Defibrillation
- Pre-Hospital Trauma Immobilization, Airway Management & IV Access
- Pre-Hospital Epinephrine, Aspirin, Nitroglycerin, Naloxone & Albuterol
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
3416L0300X — Ambulance, Land TransportPlain English: Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance | State: MT | License: 172 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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