Commmunity Ambulance Service, Inc
Organization Active NPI Land Ambulance · Rolla, ND
NPI 1346318268 · NPPES record last updated Mar 3, 2010
Key facts
- NPI
- 1346318268
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 113 (ND)
- Legal business name
- COMMMUNITY AMBULANCE SERVICE, INC
- Practice address
- 217 5TH Ave NE
Rolla, ND 58367 - Phone
- (701) 477-8818
- NPI assigned
- Nov 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Richard Griffin
- Title
- Board President
- Phone
- (701) 477-5342
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D1036694 | Community Ambulance Service - Rolla | Certificate of waiver | Feb 7, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091020000397 | ND | Part B Supplier - Ambulance Service Supplier | 1557408820 | Practice locations: Rolla, ND |
National Provider Directory
Locations
217 5th Ave NE
Rolla, ND 58367
Phone (701) 477-8818
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 113 | ND | Yes |
Addresses
Primary practice location
217 5TH Ave NE
Rolla, ND 58367
Mailing address
PO Box 872
Rolla, ND 58367-0872
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51849 | Medicaid | ND | |
| 7327 | Other | ND | BLUE CROSS BLUE SHIELD |
| P00203698 | Other | ND | RAILROAD MEDICARE |
Other names
- COMMUNITY AMBULANCE OF ROLLA
Other providers in Rolla, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2010. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.