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UPPER WEST SHORE QUICK RESPONSE UNIT
NPI 1205875978
Ambulance - Land Transport in Lakeside, MT

Active since June 06, 2006CLIA 27D2103044 · Waiver
201 BILLS RD, LAKESIDE, MT 59922(406) 844-2775(406) 844-3663 Get Directions Write a Review

NPPES record last updated: May 19, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Upper West Shore Quick Response Unit NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UPPER WEST SHORE QUICK RESPONSE UNIT (NPI 1205875978) is a healthcare organization registered as a land transport in Lakeside, Montana and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through October 4, 2027 and lists Jordan Owen, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1205875978
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameLAKESIDE QRU, INC
Location Address201 BILLS RDLakeside, MT 59922
Mailing AddressPo Box 2458Eureka, MT 59917-2458 · (406) 297-1627 · Fax (406) 297-4144
Phone(406) 844-2775
Fax(406) 844-3663
Organization SubpartNo
Authorized OfficialJordan OwenExecutive Director · (406) 844-2775
Enumeration DateJune 6, 2006
Last NPPES UpdateMay 19, 2020
NPPES CertifiedMay 19, 2020
✔ NPI 1205875978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
License✔ Licensed in MT · 152
201 BILLS RD, Lakeside, MT 59922
Open in Google Maps ↗

Other Names 1

Other NameUpper West Shore Quick Response Unit

Other Identifiers 3

Medicaid0442238MT
Other65762MT · Blue Cross Blue Shield
Other657682MT · Bc Bs

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 27D2103044

Lakeside Qru · Lakeside, MT
Active · expires Oct 4, 2027
CLIA Number27D2103044
Laboratory TypeAmbulance
Certificate Effective DateOctober 5, 2025
Certificate Expiration DateOctober 4, 2027
Laboratory DirectorMary M. Granger
Laboratory Phone(406) 844-2775
Laboratory LocationLakeside Qru201 Bill's Rd, Lakeside, MT 59922
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425
Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.
1,604 services111 patients
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) A0427
Ambulance Service, Advanced Life Support, Level 1 (ALS 1 - Emergency) is a critical care transport service for emergency situations. It includes a team of healthcare professionals equipped with advanced skills and tools to manage life-threatening conditions during transport.
85 services80 patients
Ambulance service, basic life support, emergency transport (bls-emergency) A0429
Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.
43 services38 patients

Frequently Asked Questions

What is LAKESIDE QRU, INC's NPI number?

The NPI number assigned to this healthcare provider is 1205875978, enumerated as an "organization" on June 06, 2006.

Where is the provider located?

The provider is located at 201 BILLS RD LAKESIDE, MT 59922 and the phone number is (406) 844-2775.

What is the provider's specialty?

Ambulance with taxonomy code 3416L0300X and a focus in Land Transport.

What insurance does LAKESIDE QRU, INC accept?

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.