Organization
LONGYEAR INC OF CHISHOLM
Active
Other names
Chisholm Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH SERTICH (OWNER)
(218) 312-3002
Entity
Organization
Contact information
Practice address
329 1ST ST NW, CHISHOLM, MN 55719-1703
(218) 312-3002
(218) 263-8833
Mailing address
1200 E 25TH ST, HIBBING, MN 55746-3897
(218) 312-3002
(218) 263-8933
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590002778
RAILROAD MEDICARE
MN
01
—
69127CH
BLUE CROSS BLUE SHIELD
MN
05
—
920767800
—
MN
Enumeration date
05/03/2007
Last updated
08/27/2012
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