Healthcare Provider Details

I. General information

NPI: 1447417217
Provider Name (Legal Business Name): ELY AREA AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 W CONAN ST
ELY MN
55731-1145
US

IV. Provider business mailing address

PO BOX 629
ELY MN
55731
US

V. Phone/Fax

Practice location:
  • Phone: 218-365-3271
  • Fax:
Mailing address:
  • Phone: 218-365-6322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. GEOFFREY M GALASKI
Title or Position: EXECUTIVE AMBULANCE
Credential: EMTP
Phone: 218-365-6322