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General NPI Number Information
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NPI Number | 1902965627
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Entity Type | Organization
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Legal Business Name | CITY OF STEPHEN
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 846 5TH STREET
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City | STEPHEN
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State | MN
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Zip | 56757-0289
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Country | US
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Telephone | 218-478-3864
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 630
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City | STEPHEN
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State | MN
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Zip | 56757-0630
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Country | US
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Telephone | 218-478-3614
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Fax | 218-478-3806
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Authorized Official
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Title or Position | CITY CLERK
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Name | MR. ROGER NELSON
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Credential |
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Telephone | 218-478-3614
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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 | 17741
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License Number State | MN
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