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Organization
LAKE COUNTY AMBULANCE SERVICE
Active
Organization
LAKE COUNTY AMBULANCE SERVICE
Active
Other names
Two Harbors Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DANIELLE DENEUI (DIRECTOR/CEO)
(218) 834-7110
Entity
Organization
Contact information
Practice address
421 20TH AVE, TWO HARBORS, MN 55616
(218) 834-7110
(218) 834-9587
Mailing address
421 20TH AVE, TWO HARBORS, MN 55616
(218) 834-7110
(218) 834-9587
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
0248
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5G890TW
BLUE CROSS BLUE SHEILD
MN
05
—
607524000
—
MN
Enumeration date
09/16/2005
Last updated
10/24/2013
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