Healthcare Provider Details

I. General information

NPI: 1679591929
Provider Name (Legal Business Name): EMERGENCY AMBULANCE OF DEVILS LAKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/11/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 5TH ST SE
DEVILS LAKE ND
58301-3802
US

IV. Provider business mailing address

P.O. BOX 893
DEVILS LAKE ND
58301-0893
US

V. Phone/Fax

Practice location:
  • Phone: 701-662-8832
  • Fax: 701-662-7385
Mailing address:
  • Phone: 701-662-8832
  • Fax: 701-662-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SEAN WILLIAM ROED
Title or Position: DIRECTOR OF OPERATIONS
Credential: MSEM, BSEMSA, NRP
Phone: 701-662-8916