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Organization
GREAT PLAINS EMS, INC
Active
Organization
GREAT PLAINS EMS, INC
Active
Other names
Great Plains EMS, Thief River Falls Branch
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE TALLACKSON (CLAIMS MANAGER)
(218) 681-7072
Entity
Organization
Contact information
Practice address
511 N ATLANTIC, THIEF RIVER FALLS, MN 56701
(218) 681-7072
Mailing address
PO BOX 388, THIEF RIVER FALLS, MN 56701-0388
(218) 681-7072
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3G120EM
BCBS PROVIDER NUMBER
MN
Enumeration date
12/13/2006
Last updated
09/28/2007
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