# AMBULANCE SERVICE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528023231
- **Authorized official:** MR. THOMAS M VERTIN (PRESIDENT)
- **Authorized official phone:** (218) 643-2636

## Contact information

- **Practice address:** 120 MINNESOTA AVE, BRECKENRIDGE, MN 56520-1946
- **Practice address phone:** (218) 643-2636
- **Practice address fax:** (218) 643-2637
- **Mailing address:** PO BOX 64, BRECKENRIDGE, MN 56520-0064
- **Mailing address phone:** (218) 643-2636
- **Mailing address fax:** (218) 643-2637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 0034 | MN | Yes |
| 3416L0300X | Land Ambulance | 18 | ND | — |

## Other

- **Enumeration date:** 04/18/2006
- **Last updated:** 05/01/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 501267800 | — | MN |
| 05 | — | 50766 | — | ND |
| 01 | — | 62042AM | BLUE CROSS | MN |
| 01 | — | 7932 | BLUE CROSS | ND |