Healthcare Provider Details

I. General information

NPI: 1124060884
Provider Name (Legal Business Name): NEW TOWN AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

300 MAIN ST
NEW TOWN ND
58763-4001
US

IV. Provider business mailing address

300 MAIN ST
NEW TOWN ND
58763-4001
US

V. Phone/Fax

Practice location:
  • Phone: 701-627-2992
  • Fax: 701-627-2993
Mailing address:
  • Phone: 701-627-2992
  • Fax: 701-627-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number97
License Number StateND

VIII. Authorized Official

Name: MRS. LORI ANN WOLFF
Title or Position: MANAGER
Credential: PARAMEDIC
Phone: 701-627-2992