Mott Ambulance Service
Organization Active NPI Land Ambulance · Mott, ND
NPI 1265582092 · NPPES record last updated Jul 16, 2008
Key facts
- NPI
- 1265582092
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 90 (ND)
- Legal business name
- MOTT AMBULANCE SERVICE
- Practice address
- 301 5 St E
Mott, ND 57646-0102 - Phone
- (701) 824-2391
- Fax
- (701) 824-2846
- NPI assigned
- Jan 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Betty Manolovits
- Title
- Treasurer
- Phone
- (701) 824-2391
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080623000052 | ND | Part B Supplier - Ambulance Service Supplier | 2567533326 | Practice locations: Mott, ND |
National Provider Directory
Locations
301 E 5th St
Mott, ND 58646
Phone (701) 824-2391
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 90 | ND | Yes |
Addresses
Primary practice location
301 5 St E
Mott, ND 57646-0102
Mailing address
301 5 St E
PO Box 102
Mott, ND 58646-0102
Phone (701) 824-2391
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10777 | Other | ND | BLUE SHIELD OF NORTH DAKO |
| 50242 | Medicaid | ND |
Other providers in Mott, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2008. 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.