Organization
OLIVIA AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE WERTISH (SECRETARY/TREASURER)
(320) 579-0408
Entity
Organization
Contact information
Practice address
1005 W LINCOLN AVE, OLIVIA, MN 56277
(320) 523-5565
(320) 523-1232
Mailing address
PO BOX 97, OLIVIA, MN 56277-0097
(320) 579-0408
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0183
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040406002
PRIMEWEST
MN
05
—
221267600
—
MN
01
—
47193OL
BCBS
MN
Enumeration date
08/01/2006
Last updated
05/22/2022
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