City of Cosmos
Organization Active NPI Land Ambulance · Cosmos, MN
NPI 1043417322 · NPPES record last updated Jun 10, 2014
Key facts
- NPI
- 1043417322
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 0058 (MN)
- Legal business name
- CITY OF COSMOS
- Practice address
- 233 Milky Way St. S.
Cosmos, MN 56228 - Phone
- (320) 877-7345
- Fax
- (320) 877-7678
- NPI assigned
- Jun 29, 2007
- Organization subpart
- No
Authorized official
- Name
- John Douville
- Title
- City Administrator
- Phone
- (320) 877-7345
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120605000026 | MN | Part B Supplier - Ambulance Service Supplier | 1850555822 | Practice locations: Cosmos, MN |
National Provider Directory
Locations
206 Gemini Ave E
Cosmos, MN 56228
Phone (320) 877-7345
233 Milkyway St S
Cosmos, MN 56228
216 Myrtle St W
Unit 231
Stillwater, MN 55082
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 0058 | MN | Yes |
Addresses
Primary practice location
233 Milky Way St. S.
Cosmos, MN 56228
Mailing address
PO Box 614
233 Milky Way St. S.
Cosmos, MN 56228
Phone (320) 877-7345
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 863367300 | Medicaid | MN |
Other names
- Cosmos Ambulance Service
Other providers in Cosmos, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.