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General NPI Number Information
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NPI Number | 1023179033
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Entity Type | Organization
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Legal Business Name | GREAT PLAINS EMS, INC.
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 201 W LORING ST
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City | CROOKSTON
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State | MN
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Zip | 56716-1943
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Country | US
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Telephone | 218-281-6332
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 388
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City | THIEF RIVER FALLS
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State | MN
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Zip | 56701-0388
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Country | US
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Telephone | 218-281-6332
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Fax |
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Authorized Official
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Title or Position | CLAIMS MANAGER
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Name | DIANE TALLACKSON
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Credential |
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Telephone | 218-281-6332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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