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General NPI Number Information
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NPI Number | 1447115381
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Entity Type | Organization
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Legal Business Name | LEWISVILLE AMBULANCE SERVICE
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 321 LEWIS ST. W
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City | LEWISVILLE
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State | MN
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Zip | 56060
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Country | US
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Telephone | 507-508-4300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 142
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City | LEWISVILLE
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State | MN
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Zip | 56060-0142
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Country | US
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Telephone | 507-508-4300
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Fax |
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Authorized Official
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Title or Position | TREASURER AND EMT
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Name | DR. KELLY BLAINE PULTS
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Credential | DHA, MSN, RN, NREMT
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Telephone | 303-908-2833
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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 |
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License Number State |
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