MEDICARE: NEW SALEM AMBULANCE SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	096	ND

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7159	OTHER	ND	BLUE CROSS BLUE SHIELD
3	590095465	OTHER	ND	RAILROAD MEDICAR

General Provider Information

NPI Number	:	1790856706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW SALEM AMBULANCE SERVICE

Provider Business Mailing Address
First Line	:	PO BOX 87
Second Line	:
City	:	NEW SALEM
State	:	ND
Zip	:	58563-0087
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 MAIN AVE
Second Line	:
City	:	NEW SALEM
State	:	ND
Zip	:	58563
Country	:	US
Telephone Number	:	701-391-2953
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	ANN SCHNEIDER
Credential	:
Telephone Number	:	701-391-2953

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	06/17/2008

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Directions to “NEW SALEM AMBULANCE SERVICE ” Practice Location

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