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General NPI Number Information
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NPI Number | 1528269149
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Entity Type | Organization
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Legal Business Name | UPHAM FIRE PROTECTION
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 117 C AVE S
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City | UPHAM
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State | ND
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Zip | 58789
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Country | US
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Telephone | 701-768-2925
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Fax | 701-768-2925
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Provider Business Mailing Address
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Address Line | 117 C AVE S
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City | UPHAM
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State | ND
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Zip | 58789
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Country | US
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Telephone | 701-768-2925
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Fax | 701-768-2925
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Authorized Official
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Title or Position | SQUAD LEADER
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Name | KOLENA DRADER
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Credential |
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Telephone | 701-768-2664
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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 | 124
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License Number State | ND
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