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General NPI Number Information
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NPI Number | 1477659860
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Entity Type | Organization
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Legal Business Name | LARIMORE AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 420 TOWNER AVE
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City | LARIMORE
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State | ND
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Zip | 58251-0365
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Country | US
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Telephone | 701-343-6293
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Fax | 701-343-6497
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Provider Business Mailing Address
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Address Line | PO BOX 365
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City | LARIMORE
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State | ND
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Zip | 58251-0365
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Country | US
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Telephone | 701-343-6293
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Fax | 701-343-6497
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ROBERT JOSEPH BAUER
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Credential | NREMTI
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Telephone | 701-343-6293
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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 | 069
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License Number State | ND
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