Organization
GREAT PLAINS EMS, INC
Active
Other names
Great Plains EMS, Thief River Falls Branch
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE TALLACKSON (CLAIMS MANAGER)
(218) 681-7072
Entity
Organization
Contact information
Practice address
511 N ATLANTIC, THIEF RIVER FALLS, MN 56701
(218) 681-7072
Mailing address
PO BOX 388, THIEF RIVER FALLS, MN 56701-0388
(218) 681-7072
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3G120EM
BCBS PROVIDER NUMBER
MN
Enumeration date
12/13/2006
Last updated
09/28/2007
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