Organization
WHITE EARTH BAND OF CHIPPEWA
Active
Other names
White Earth Reservation Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
KIM HOGLUND (BILLING MANAGER)
(218) 936-5586
Entity
Organization
Contact information
Practice address
26246 CRANE RD, WHITE EARTH, MN 56591-9998
(218) 983-3285
(218) 983-4299
Mailing address
PO BOX 328, WHITE EARTH, MN 56591-0328
(218) 983-3285
(218) 983-4299
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0354
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56M66WH
BLUE CROSS BLUE SHIELD
MN
01
—
8183263
MEDICA
MN
Enumeration date
08/08/2006
Last updated
01/07/2008
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