Organization
BERTHOLD AMBULANCE SERVICES
Active
Organization
BERTHOLD AMBULANCE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICHOLE J DEGENSTEIN (SEC/TRES)
(701) 721-7316
Entity
Organization
Contact information
Practice address
15 3RD AVE NW, BERTHOLD, ND 58718
(701) 721-7316
(701) 453-3299
Mailing address
PO BOX 176, BERTHOLD, ND 58718
(701) 721-7316
(701) 453-3299
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
006
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52290
—
ND
01
—
590015360
RAILROAD MEDICAL PROVIDER
ND
01
—
7532
ND BLUE CROSS BLUE SHIELD
ND
Enumeration date
04/17/2007
Last updated
12/20/2012
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