1982793030 NPI number — OLIVER COUNTY AMBULANCE ASSOCIATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982793030 NPI number — OLIVER COUNTY AMBULANCE ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OLIVER COUNTY AMBULANCE ASSOCIATION
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:
6
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:
1982793030
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 397
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTER
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58530-0397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 MAIN ST. E.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTER
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58530-0397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-794-8828
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALBERS
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER/BOOKKEEPER
Authorized Official Telephone Number:
701-794-8770

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , 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: 52028 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: OLI7441 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".




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