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General NPI Number Information
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NPI Number | 1235437864
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Entity Type | Organization
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Legal Business Name | CITY OF VIRGINIA
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 1004 SOUTH 2ND AVE
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City | VIRGINIA
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State | MN
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Zip | 55792
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Country | US
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Telephone | 218-748-7520
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 SOUTH 2ND AVE
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City | VIRGINIA
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State | MN
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Zip | 55792
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Country | US
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Telephone | 218-748-7520
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Fax |
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Authorized Official
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Title or Position | CHIEF
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Name | MR. SCOTT FREDRICKSON
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Credential |
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Telephone | 218-748-7523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 0250
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License Number State | MN
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Taxonomy #2
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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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