# CITY OF KERKHOVEN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kerkhoven Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447310271
- **Authorized official:** THOMAS DAHL (DIRECTOR)
- **Authorized official phone:** (320) 264-2581

## Contact information

- **Practice address:** 202 9TH STREET N, KERKHOVEN, MN 56252
- **Practice address phone:** (218) 233-5658
- **Mailing address:** PO BOX 364, MOORHEAD, MN 56561-0364
- **Mailing address phone:** (218) 233-5658
- **Mailing address fax:** (218) 233-7630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 0122 | MN | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 01/13/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 45379KE | BLUE CROSS BLUE SHIELD | MN |
| 05 | — | 916024800 | — | MN |