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Organization
AMBULANCE SERVICE INC
Active
Organization
AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS M VERTIN (PRESIDENT)
(218) 643-2636
Entity
Organization
Contact information
Practice address
120 MINNESOTA AVE, BRECKENRIDGE, MN 56520-1946
(218) 643-2636
(218) 643-2637
Mailing address
PO BOX 64, BRECKENRIDGE, MN 56520-0064
(218) 643-2636
(218) 643-2637
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0034
MN
3416L0300X
Land Ambulance
18
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501267800
—
MN
05
—
50766
—
ND
01
—
62042AM
BLUE CROSS
MN
01
—
7932
BLUE CROSS
ND
Enumeration date
04/18/2006
Last updated
05/01/2012
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