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General NPI Number Information
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NPI Number | 1376623124
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Entity Type | Organization
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Legal Business Name | GOODRICH AMBULANCE SERVICE
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 122 MCKINLEY
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City | GOODRICH
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State | ND
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Zip | 58444
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Country | US
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Telephone | 701-884-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 141 19TH AVE SE
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City | GOODRICH
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State | ND
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Zip | 58444-9373
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | NANCY SCHNEIDER
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Credential |
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Telephone | 701-884-2727
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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 | 046
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License Number State | ND
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