Organization
CITY OF STEPHEN
Active
Parent organization
CITY OF STEPHEN
Other names
Stephen Volunteer Ambulance Service
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITY OF STEPHEN
Authorized official
MR. ROGER NELSON (CITY CLERK)
(218) 478-3614
Entity
Organization
Contact information
Practice address
846 5TH STREET, STEPHEN, MN 56757-0289
(218) 478-3864
Mailing address
PO BOX 630, STEPHEN, MN 56757-0630
(218) 478-3614
(218) 478-3806
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
17741
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093867000
—
MN
01
—
170709
BLUE CROSS BLUE SHIELD-MN
MN
Enumeration date
12/08/2006
Last updated
11/27/2013
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