# CITY OF STEPHEN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CITY OF STEPHEN
- **Other names:** Stephen Volunteer Ambulance Service
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902965627
- **Legal business name:** CITY OF STEPHEN
- **Authorized official:** MR. ROGER NELSON (CITY CLERK)
- **Authorized official phone:** (218) 478-3614

## Contact information

- **Practice address:** 846 5TH STREET, STEPHEN, MN 56757-0289
- **Practice address phone:** (218) 478-3864
- **Mailing address:** PO BOX 630, STEPHEN, MN 56757-0630
- **Mailing address phone:** (218) 478-3614
- **Mailing address fax:** (218) 478-3806

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 17741 | MN | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 11/27/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 093867000 | — | MN |
| 01 | — | 170709 | BLUE CROSS BLUE SHIELD-MN | MN |