Healthcare Provider Details

I. General information

NPI: 1386660843
Provider Name (Legal Business Name): MERCER COUNTY AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 4TH ST NE
HAZEN ND
58545-4653
US

IV. Provider business mailing address

801 4TH ST NE
HAZEN ND
58545-4653
US

V. Phone/Fax

Practice location:
  • Phone: 701-748-7283
  • Fax: 701-748-5559
Mailing address:
  • Phone: 701-748-7283
  • Fax: 701-748-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MARCIA MARIE STEFFEN
Title or Position: MANAGER
Credential:
Phone: 701-748-7241