Edmore Volunteer Fire Department

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

32 Issued in ND

Legal business name

EDMORE VOLUNTEER FIRE DEPARTMENT

Doing business as

Edmore Ambulance Service

Practice address

303 S Madison St
Edmore, ND 58330-7702

Phone

(701) 256-0787

NPI assigned

Jan 21, 2010

Last updated

Aug 13, 2024By 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

Lisa Pesek

Title

Manager

Phone

(701) 256-0787

Specialties & licenses 1

Addresses

Other names 1

• EDMORE AMBULANCE SERVICE Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1487985008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SOUTH MADISON STREET",
            "address_2": "PO BOX 6",
            "city": "EDMORE",
            "state": "ND",
            "postal_code": "583300006",
            "telephone_number": "701-644-2204",
            "fax_number": "701-644-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S MADISON ST",
            "city": "EDMORE",
            "state": "ND",
            "postal_code": "583307702",
            "telephone_number": "701-256-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMORE VOLUNTEER FIRE DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "PESEK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "701-256-0787"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ND",
            "license": "32",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDMORE AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coral Berg
• City of Edmore (Edmore Ambulance)
• Edmore Memorial Rest Home
• Larry D Legacie, DDS
• Michelle A Williams

• Land Ambulance in Edmore, ND
• Providers in Edmore, ND by specialty
• Land Ambulance in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.