=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801956644
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WINTHROP AMBULANCE SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2006
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 305 NORTH MAIN STREET
-----------------------------------------------------
City | WINTHROP
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-647-5306
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX Y
-----------------------------------------------------
City | WINTHROP
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55396-0510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-647-5306
-----------------------------------------------------
Fax | 507-647-3200
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLERK/TREASURER
-----------------------------------------------------
Name | HEATHER HAUN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 507-647-5306
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 0274
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------