# CITY OF RAYMOND

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Raymond Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891907697
- **Authorized official:** DIANE TALLACKSON (CLAIMS MANAGER)
- **Authorized official phone:** (651) 653-2201

## Contact information

- **Practice address:** 314 SPICER STREET, RAYMOND, MN 56282-9998
- **Practice address phone:** (320) 967-4226
- **Mailing address:** PO BOX 216, RAYMOND, MN 56282-0216
- **Mailing address phone:** (651) 653-2201
- **Mailing address fax:** (651) 653-2213

## Taxonomy

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

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 03/14/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 986313300 | — | MN |
| 01 | — | BCBS | 45656RA | MN |