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General NPI Number Information
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NPI Number | 1497831705
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Entity Type | Organization
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Legal Business Name | GUNFLINT TRAIL VOLUNTEER FIRE DEPARTMENT
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Dates
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Enumeration Date | 10/29/2006
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 112 S GUNFLINT LK RD
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City | GRAND MARAIS
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State | MN
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Zip | 55604
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Country | US
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Telephone | 218-388-0314
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Fax | 218-388-0102
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Provider Business Mailing Address
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Address Line | 7401 GUNFLINT TRL
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City | GRAND MARAIS
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State | MN
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Zip | 55604-2022
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Country | US
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Telephone | 218-388-0314
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Fax | 218-388-0102
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Authorized Official
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Title or Position | AMBULANCE MANAGER
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Name | LAURA DAHL POPKES
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Credential | EMT-B
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Telephone | 218-388-9491
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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 | 0388
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License Number State | MN
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