Lake County Ambulance Service

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

LAKE COUNTY AMBULANCE SERVICE

Doing business as

Two Harbors Ambulance

Practice address

421 20TH Ave
Two Harbors, MN 55616

Phone

(218) 834-7110

Fax

(218) 834-9587

NPI assigned

Sep 16, 2005

Last updated

Oct 24, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Danielle Deneui

Title

Director/Ceo

Phone

(218) 834-7110

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Two Harbors Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Lake County Ambulance SVC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lake County Ambulance

  dba Silver Bay Ambulance

  • Land Ambulance
  • Silver Bay, MN
  • NPI 1073683017
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1457346223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 20TH AVE",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "55616",
            "telephone_number": "218-834-7110",
            "fax_number": "218-834-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 20TH AVE",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "55616",
            "telephone_number": "218-834-7110",
            "fax_number": "218-834-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "DENEUI",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "DIRECTOR/CEO",
        "authorized_official_telephone_number": "218-834-7110",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MN",
            "license": "0248",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "607524000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "5G890TW",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Two Harbors Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Daniel Keller
• Katrina M Klessig
• Kristen Lyn Klos-Maki, D.C.
• Chloe Knop
• Lake County
• Lake View Clinic (Aspirus Lake View Two Harbors Clinic)
• Lake View Memorial Hospital, Inc (Aspirus Lake View Hospital)
• Lake View Memorial Hospital, Inc
• Lake View Memorial Hospital, Inc (Aspirus Lake View Hospital Urgent Care)
• Lake View Memorial Hospital, Inc. (Aspirus Lake View Hospital)

• Ambulance in Two Harbors, MN
• Providers in Two Harbors, MN by specialty
• Ambulance in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.