Healthcare Provider Details
I. General information
NPI: 1922004092
Provider Name (Legal Business Name): METRO AREA AMBULANCE SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/23/2005
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2940 N 19TH ST
BISMARCK ND
58503-5393
US
IV. Provider business mailing address
PO BOX 595
MANDAN ND
58554-0595
US
V. Phone/Fax
- Phone: 701-255-0812
- Fax: 701-255-7247
- Phone: 701-255-0812
- Fax: 701-255-7247
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | 012 |
| License Number State | ND |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TODD
PORTER
Title or Position: DIRECTOR
Credential:
Phone: 701-255-0812