Organization
BOTTINEAU AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN THOMAS OMVIG (TREASURER)
(701) 228-3669
Entity
Organization
Contact information
Practice address
323 BENNETT ST, BOTTINEAU, ND 58318
(701) 228-3669
Mailing address
1310 THOMPSON ST, BOTTINEAU, ND 58318-2031
(701) 228-3669
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0014
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050160 ND
—
ND
01
—
7024
BCBS
ND
Enumeration date
02/21/2008
Last updated
02/21/2008
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