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Organization

PLAZA AMBULANCE SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY LAVERNE JOHNSON (SQUAD LEADER)
(701) 497-3766
Entity
Organization

Contact information

Practice address
308 4TH AVE., PLAZA, ND 58771-0057
(701) 497-3766
(701) 497-3779
Mailing address
308 4TH AVE., PLAZA, ND 58771-0057
(701) 497-3766
(701) 497-3779

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
104
ND

Other

Enumeration date
02/16/2011
Last updated
02/16/2011
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