Red Lake Falls Volunteer Ambulance Association

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

RED LAKE FALLS VOLUNTEER AMBULANCE ASSOCIATION

Practice address

201 Champagne Ave SW
Red Lake Falls, MN 56750-4003

Phone

(651) 653-2201

NPI assigned

May 1, 2007

Organization subpart

No

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

Authorized official

Name

Diane Tallackson

Title

Claims Manager

Phone

(651) 653-2201

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386115200000",
    "number": "1770704587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194",
            "city": "RED LAKE FALLS",
            "state": "MN",
            "postal_code": "567500194",
            "telephone_number": "651-653-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CHAMPAGNE AVE SW",
            "city": "RED LAKE FALLS",
            "state": "MN",
            "postal_code": "567504003",
            "telephone_number": "651-653-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED LAKE FALLS VOLUNTEER AMBULANCE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2013-12-04",
        "status": "A",
        "authorized_official_last_name": "TALLACKSON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CLAIMS MANAGER",
        "authorized_official_telephone_number": "651-653-2201"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "63663RE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "491567400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ind School District 630
• Inspire Independence Therapy LLC
• Jo Lambert
• Lesmeister Dental LLC (Lesmeister Dental)
• Red Lake County Social Services
• Riverview Healthcare Association
• Riverview Healthcare Association (Hillcrest Nursing Home)
• Richard Walter Seeger, RPH
• Thrifty Drug Stores Inc (Thrifty White Pharmacy #740)

• Land Ambulance in Red Lake Falls, MN
• Providers in Red Lake Falls, MN by specialty
• Land Ambulance in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.