1366784126 NPI number — BOWDON AMBULANCE SERVICE DISTRICT

Table of content: DR. WILLIAM FRANK WRIGHT DDS (NPI 1417937566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366784126 NPI number — BOWDON AMBULANCE SERVICE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOWDON AMBULANCE SERVICE 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:
1366784126
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
211 WARRINGTON AVE
Provider Second Line Business Mailing Address:
PO BOX 27
Provider Business Mailing Address City Name:
BOWDON
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58418-0027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-962-3646
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 WARRINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOWDON
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-962-3646
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FLICK
Authorized Official First Name:
CHERYL
Authorized Official Middle Name:
Authorized Official Title or Position:
BOARD PRESIDENT
Authorized Official Telephone Number:
701-324-4483

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  016 , 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: 56179 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".