Organization
GLEN ULLIN AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA DUPPONG (SQUAD LEADER)
(701) 348-3274
Entity
Organization
Contact information
Practice address
206 2ND ST SOUTH, GLEN ULLIN, ND 58631
(701) 348-3274
Mailing address
PO BOX 974, MANDAN, ND 58554-0974
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
44
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052187
—
ND
01
—
GLE7178
BLUE CROSS ND
ND
Enumeration date
11/15/2006
Last updated
09/21/2007
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