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General NPI Number Information
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NPI Number | 1487685947
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Entity Type | Organization
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Legal Business Name | LAKES REGION EMS, INC.
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 40245 FLETCHER AVE
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City | NORTH BRANCH
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State | MN
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Zip | 55056-6109
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Country | US
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Telephone | 651-243-5505
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Fax | 651-674-4628
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Provider Business Mailing Address
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Address Line | 40245 FLETCHER AVE
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City | NORTH BRANCH
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State | MN
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Zip | 55056-6109
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Country | US
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Telephone | 651-243-5505
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Fax | 651-674-4628
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Authorized Official
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Title or Position | DIRECTOR OF ADMINSTRATION
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Name | MICHELLE ANDERSON
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Credential |
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Telephone | 651-243-5502
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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 | 0177
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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 | 0211
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 0048
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License Number State | MN
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