Organization
MADDOCK AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE RASMUSSEN (SECRETARY TREASURER)
(701) 438-2319
Entity
Organization
Contact information
Practice address
206 LINCOLN AVE, MADDOCK, ND 58348-0208
(701) 438-2319
Mailing address
PO BOX 208, MADDOCK, ND 58348-0208
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
074
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50942
—
ND
01
—
7189
BLUE CROSS BLUE SHIELD
ND
01
—
P00075504
RAILROAD MEDICARE
ND
Enumeration date
01/05/2007
Last updated
10/21/2009
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