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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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