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Organization
WHITE EARTH BAND OF CHIPPEWA
Active
Organization
WHITE EARTH BAND OF CHIPPEWA
Active
Other names
White Earth Reservation Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
KIM HOGLUND (BILLING MANAGER)
(218) 936-5586
Entity
Organization
Contact information
Practice address
26246 CRANE RD, WHITE EARTH, MN 56591-9998
(218) 983-3285
(218) 983-4299
Mailing address
PO BOX 328, WHITE EARTH, MN 56591-0328
(218) 983-3285
(218) 983-4299
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0354
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56M66WH
BLUE CROSS BLUE SHIELD
MN
01
—
8183263
MEDICA
MN
Enumeration date
08/08/2006
Last updated
01/07/2008
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