Organization
MOTT AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY MANOLOVITS (TREASURER)
(701) 824-2391
Entity
Organization
Contact information
Practice address
301 5 ST E, MOTT, ND 57646-0102
(701) 824-2391
(701) 824-2846
Mailing address
301 5 ST E, PO BOX 102, MOTT, ND 58646-0102
(701) 824-2391
(701) 824-2846
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
90
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10777
BLUE SHIELD OF NORTH DAKO
ND
05
—
50242
—
ND
Enumeration date
01/12/2007
Last updated
07/16/2008
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