Organization
PEMBINA AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WILLIAMS (SECRETARY / TREASURER)
(701) 825-6868
Entity
Organization
Contact information
Practice address
152 W ROLETTE ST STE 3, PEMBINA, ND 58271-4442
(701) 825-6868
Mailing address
PO BOX 131, PEMBINA, ND 58271-0131
(701) 825-6868
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
103
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11320
BLUE CROSS BLUE SHIELD
ND
05
—
51223
—
ND
01
—
590013486
RAILROAD MEDICARE
ND
Enumeration date
10/09/2006
Last updated
01/14/2010
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