Healthcare Provider Details

I. General information

NPI: 1992723944
Provider Name (Legal Business Name): CITY OF BIWABIK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 3RD AVENUE NORTH
BIWABIK MN
55708-0529
US

IV. Provider business mailing address

3920 13TH AVE E SUITE 6
HIBBING MN
55746-3675
US

V. Phone/Fax

Practice location:
  • Phone: 218-865-4183
  • Fax: 218-865-4580
Mailing address:
  • Phone: 218-263-7540
  • Fax: 866-732-0699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0027
License Number StateMN

VIII. Authorized Official

Name: JEFF JACOBSON
Title or Position: CITY ADMINISTRATOR
Credential:
Phone: 218-865-4183