# RED LAKE FALLS VOLUNTEER AMBULANCE ASSOCIATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1770704587
- **Authorized official:** DIANE TALLACKSON (CLAIMS MANAGER)
- **Authorized official phone:** (651) 653-2201

## Contact information

- **Practice address:** 201 CHAMPAGNE AVE SW, RED LAKE FALLS, MN 56750-4003
- **Practice address phone:** (651) 653-2201
- **Mailing address:** PO BOX 194, RED LAKE FALLS, MN 56750-0194
- **Mailing address phone:** (651) 653-2201

## Taxonomy

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

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 12/04/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 491567400 | — | MN |
| 01 | — | 63663RE | BCBS | MN |