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General NPI Number Information
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NPI Number | 1609926013
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Entity Type | Organization
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Legal Business Name | CITY OF ELLENDALE
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 55 3RD AVE S
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City | ELLENDALE
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State | ND
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Zip | 58436
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Country | US
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Telephone | 701-349-3364
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Fax | 701-349-3333
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Provider Business Mailing Address
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Address Line | PO BOX 267
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City | ELLENDALE
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State | ND
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Zip | 58436-0267
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Country | US
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Telephone | 701-349-3364
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Fax | 701-349-3333
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Authorized Official
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Title or Position | MANAGER
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Name | MR. COREY ERWIN GULKE
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Credential | NREMT-P
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Telephone | 701-349-3364
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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 | 33
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License Number State | ND
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