Organization
EMCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY TAYLOR MANAGER (REGIONAL MANAGER)
(800) 444-7009
Entity
Organization
Contact information
Practice address
PHS INDIAN HOSPITAL HWY 1 PO 497, RED LAKE, MN 56671
(218) 679-3912
(218) 679-0181
Mailing address
11235 OAK LEAF DR APT # 1515, SILVER SPRING, MD 20901
(210) 260-1290
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
D0065884
MD
Other
Enumeration date
05/14/2007
Last updated
09/11/2009
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