Drayton Volunteer Ambulance Association
Organization Active NPI Land Ambulance · Drayton, ND
NPI 1457405698 · NPPES record last updated Apr 1, 2013
Key facts
- NPI
- 1457405698
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- DRAYTON VOLUNTEER AMBULANCE ASSOCIATION
- Practice address
- 105 Grant Ave
Drayton, ND 58225-0238 - Phone
- (701) 454-6505
- Fax
- (701) 454-3817
- NPI assigned
- Jan 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Andrew D Duncklee
- Title
- Coordinator
- Phone
- (701) 454-6119
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D2211606 | Drayton Volunteer Ambulance Association Inc | Certificate of waiver | Jan 27, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100312001034 | ND | Part B Supplier - Ambulance Service Supplier | 9234264482 | Practice locations: Drayton, ND |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | ND | Yes |
Addresses
Primary practice location
105 Grant Ave
Drayton, ND 58225-0238
Mailing address
PO Box 238
Drayton, ND 58225-0238
Phone (701) 454-6505
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7302 | Other | ND | BLUE CROSS BLUE SHIELD |
| 51616 | Medicaid | ND |
Other providers in Drayton, ND
- Altru Health System
- Catherine Jean Hengel Borud
- Catherine J H Borud DC
- Drayton Drug Inc
- Drayton Eye Clinic
- Andrew D Duncklee
- Marlene Kay Gunderson
- Jacqueline K Hoselton
- Corey Merrill
- Ye Olde Medicine Shoppe Inc
All providers in Drayton, ND · Land Ambulance in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2013. 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.