Healthcare Provider Details

I. General information

NPI: 1811084494
Provider Name (Legal Business Name): CITY OF ST. JAMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 ARMSTRONG BLVD S
SAINT JAMES MN
56081-1760
US

IV. Provider business mailing address

124 ARMSTRONG BLVD S
SAINT JAMES MN
56081-1760
US

V. Phone/Fax

Practice location:
  • Phone: 507-375-3241
  • Fax: 507-375-4376
Mailing address:
  • Phone: 507-375-3241
  • Fax: 507-375-4376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0216
License Number StateMN

VIII. Authorized Official

Name: GARY L STURM
Title or Position: MAYOR
Credential:
Phone: 507-375-3241