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Organization
RED LAKE FALLS VOLUNTEER AMBULANCE ASSOCIATION
Active
Organization
RED LAKE FALLS VOLUNTEER AMBULANCE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE TALLACKSON (CLAIMS MANAGER)
(651) 653-2201
Entity
Organization
Contact information
Practice address
201 CHAMPAGNE AVE SW, RED LAKE FALLS, MN 56750-4003
(651) 653-2201
Mailing address
PO BOX 194, RED LAKE FALLS, MN 56750-0194
(651) 653-2201
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
491567400
—
MN
01
—
63663RE
BCBS
MN
Enumeration date
05/01/2007
Last updated
12/04/2013
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