Organization Name: | CROOKSTON AREA AMBULANCE, INC. |
NPI Number: | 1093910838 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARRET J WICKLUND (PRESIDENT) |
Mailing Address: | 201 W Loring St Crookston |
State: | MN US |
Postal Code: | 567161943 |
Phone Number: | 2182335658 |
Fax Number: | |
NPI Enumeration Date: | 06/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416L0300X |
License Number: | #0305 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Land Transport |
Taxonomy Definition: |