Healthcare Provider Details

I. General information

NPI: 1245390129
Provider Name (Legal Business Name): REGENT AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 WEST 2ND STREET
REGENT ND
57650
US

IV. Provider business mailing address

PO BOX 91
REGENT ND
58650-0091
US

V. Phone/Fax

Practice location:
  • Phone: 218-233-5658
  • Fax:
Mailing address:
  • Phone: 218-233-5658
  • Fax: 218-233-7630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TERRY HARTMANN
Title or Position: PRESIDENT
Credential:
Phone: 218-233-5658