Healthcare Provider Details

I. General information

NPI: 1497831705
Provider Name (Legal Business Name): GUNFLINT TRAIL VOLUNTEER FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2006
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S GUNFLINT LK RD
GRAND MARAIS MN
55604
US

IV. Provider business mailing address

7401 GUNFLINT TRL
GRAND MARAIS MN
55604-2022
US

V. Phone/Fax

Practice location:
  • Phone: 218-388-0314
  • Fax: 218-388-0102
Mailing address:
  • Phone: 218-388-0314
  • Fax: 218-388-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0388
License Number StateMN

VIII. Authorized Official

Name: LAURA DAHL POPKES
Title or Position: AMBULANCE MANAGER
Credential: EMT-B
Phone: 218-388-9491