Organization
RENVILLE AMBULANCE SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE WERTISH (OFFICE MANAGER)
(320) 579-0408
Entity
Organization
Contact information
Practice address
115 E PARK AVE, RENVILLE, MN 56284
(320) 579-0408
Mailing address
PO BOX 703, RENVILLE, MN 56284-0703
(320) 523-5565
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0207
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040406003
PRIMEWEST
MN
01
—
47255RE
BCBS
MN
05
—
593267000
—
MN
Enumeration date
08/01/2006
Last updated
05/22/2022
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