Organization
BLACKDUCK AMBULANCE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT SORENSEN (AMBULANCE MANAGER)
(218) 835-4800
Entity
Organization
Contact information
Practice address
55 RAILROAD AVENUE, BLACKDUCK, MN 56630
(218) 835-4800
Mailing address
3920 13TH AVE E, SUITE 6, HIBBING, MN 55746-3675
(218) 263-7540
(866) 732-0699
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6G209BL
BCBS
MN
Enumeration date
08/16/2006
Last updated
04/18/2008
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