Healthcare Provider Details

I. General information

NPI: 1174601561
Provider Name (Legal Business Name): GRAND MEADOW AREA AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE 2 ST
GRAND MEADOW MN
55936-1027
US

IV. Provider business mailing address

200 2 ST SE P.O. BOX 1027
GRAND MEADOW MN
55936-1027
US

V. Phone/Fax

Practice location:
  • Phone: 507-754-5150
  • Fax: 507-754-6150
Mailing address:
  • Phone: 507-754-5150
  • Fax: 507-754-6150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0096
License Number StateMN

VIII. Authorized Official

Name: MEGHAN B. LAMP
Title or Position: AMBULANCE DIRECTOR
Credential: R.N.
Phone: 507-754-5908