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General NPI Number Information
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NPI Number | 1548327778
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Entity Type | Organization
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Legal Business Name | PERHAM AREA EMS
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 525 W MAIN ST
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City | PERHAM
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State | MN
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Zip | 56573-1457
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Country | US
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Telephone | 218-346-4440
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Fax | 218-346-9795
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Provider Business Mailing Address
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Address Line | 525 W MAIN ST
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City | PERHAM
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State | MN
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Zip | 56573-1457
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Country | US
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Telephone | 218-346-4440
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Fax | 218-346-9795
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Authorized Official
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Title or Position | DIRECTOR OF EMS
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Name | DOUGLAS NELS HARTHAN
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Credential | NREMT-P
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Telephone | 218-346-4485
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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 | MN017
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License Number State | MN
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