1538369780 NPI number — HANKINSON AMBULANCE DISTRICT

Table of content: (NPI 1538369780)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538369780 NPI number — HANKINSON AMBULANCE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HANKINSON AMBULANCE DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538369780
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 96
Provider Second Line Business Mailing Address:
102 MAIN AVE N
Provider Business Mailing Address City Name:
HANKINSON
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58041-0096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-242-7780
Provider Business Mailing Address Fax Number:
701-242-7786

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 MAIN AVE N
Provider Second Line Business Practice Location Address:
HANKINSON FIRE & AMBULANCE MEETING ROOM
Provider Business Practice Location Address City Name:
HANKINSON
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-242-7780
Provider Business Practice Location Address Fax Number:
701-242-7786
Provider Enumeration Date:
07/24/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KRUMP
Authorized Official First Name:
ARLENE
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
701-242-7780

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  051 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7458 . This is a "BCBS" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 56883 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".