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General NPI Number Information
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NPI Number | 1053471888
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Entity Type | Organization
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Legal Business Name | PARKERS PRAIRIE COMMUNITY AMBULANCE
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 102 NORTH OTTER AVENUE
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City | PARKERS PRAIRIE
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State | MN
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Zip | 56361
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Country | US
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Telephone | 218-233-5658
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 115
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City | PARKERS PRAIRIE
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State | MN
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Zip | 56361-0115
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Country | US
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Telephone | 218-233-5658
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Fax | 218-233-7630
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Authorized Official
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Title or Position | AMBULANCE ADMINISTRATOR
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Name | ROBERT HUCKLE
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Credential |
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Telephone | 218-338-4357
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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 | 0188
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License Number State | MN
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