Organization
PORTAL AMBULANCE
Active
Other names
Portal International Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANN KNUTSON EMT-I85 (SQUAD LEADER)
(701) 933-2878
Entity
Organization
Contact information
Practice address
301 CLARK ST, PORTAL, ND 58772
(701) 839-6326
Mailing address
PO BOX 61, PORTAL, ND 58752-0061
(701) 933-2878
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
105
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50505
—
ND
01
—
590013588
RAILROAD MEDICARE
ND
01
—
7409
BLUE CROSS BLUE SHIELD
ND
Enumeration date
11/15/2006
Last updated
06/10/2013
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