Organization Name: | SPRING GROVE AMBULANCE SERVICE |
NPI Number: | 1881764041 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRUMAN O TILLERAAS (TREASURER) |
Mailing Address: | 192 West Main St Spring Grove |
State: | MN US |
Postal Code: | 55974 |
Phone Number: | 5074985221 |
Fax Number: | 5074985298 |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 05/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416L0300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Land Transport |
Taxonomy Definition: |