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General NPI Number Information
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NPI Number | 1689697062
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Entity Type | Organization
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Legal Business Name | WEST TRAILL AMBULANCE SERVICE, INC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 43 7TH AVE SE
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City | MAYVILLE
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State | ND
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Zip | 58257
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Country | US
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Telephone | 701-371-2827
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Fax | 888-964-8168
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Provider Business Mailing Address
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Address Line | PO BOX 545
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City | MAYVILLE
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State | ND
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Zip | 58257-0545
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Country | US
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Telephone | 701-371-2827
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Fax | 888-964-8168
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEFAN HOFER
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Credential |
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Telephone | 701-371-2827
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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 | 77
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License Number State | ND
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