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General NPI Number Information
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NPI Number | 1548366248
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Entity Type | Organization
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Legal Business Name | ELK RIVER FIRE & AMBULANCE SERVICE
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 415 JACKSON AVE NW
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City | ELK RIVER
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State | MN
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Zip | 55330-1327
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Country | US
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Telephone | 763-441-2733
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Fax | 763-441-4050
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Provider Business Mailing Address
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Address Line | 415 JACKSON AVE NW
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City | ELK RIVER
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State | MN
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Zip | 55330-1327
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Country | US
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Telephone | 763-441-2733
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Fax | 763-441-4050
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Authorized Official
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Title or Position | AMBULANCE COORDINATOR
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Name | MR. STEVEN LEE DITTBENNER
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Credential | PARAMEDIC
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Telephone | 763-441-2733
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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 | 073
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License Number State | MN
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