Ambulance Service Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0034 Issued in MN

Legal business name

AMBULANCE SERVICE INC

Practice address

120 Minnesota Ave
Breckenridge, MN 56520-1946

Phone

(218) 643-2636

Fax

(218) 643-2637

NPI assigned

Apr 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Thomas M Vertin

Title

President

Phone

(218) 643-2636

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1528023231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565200064",
            "telephone_number": "218-643-2636",
            "fax_number": "218-643-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINNESOTA AVE",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201946",
            "telephone_number": "218-643-2636",
            "fax_number": "218-643-2637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "VERTIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-643-2636",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MN",
            "license": "0034",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ND",
            "license": "18",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50766",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "7932",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501267800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "62042AM",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Kay Albertson
• Crystal E Asche, LPCC, LPC, NCC
• Stacie Bellmore, COTA
• Heidi J Bertsch, PHARM D, RPH
• Tiffany Blinn, DPT
• Renata Raye Bosek

• Land Ambulance in Breckenridge, MN
• Providers in Breckenridge, MN by specialty
• Land Ambulance in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.