Grenora Ambulance Service
Organization Active NPI Land Ambulance · Grenora, ND
NPI 1780734285 · NPPES record last updated Jan 7, 2010
Key facts
- NPI
- 1780734285
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 049 (ND)
- Legal business name
- GRENORA AMBULANCE SERVICE
- Practice address
- 205 Main Street
Grenora, ND 58845-0274 - Phone
- (701) 694-3391
- Fax
- (701) 694-3392
- NPI assigned
- Jan 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Jane Schenstad
- Title
- Secretary Squad Leader
- Phone
- (701) 694-3391
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D2320699 | Grenora Ambulance Service | Certificate of waiver | Mar 23, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100219000178 | ND | Part B Supplier - Ambulance Service Supplier | 3375687015 | Practice locations: Grenora, ND |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 049 | ND | Yes |
Addresses
Primary practice location
205 Main Street
Grenora, ND 58845-0274
Mailing address
PO Box 274
Grenora, ND 58845-0274
Phone (701) 694-3391
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50828 | Medicaid | ND | |
| 7138 | Other | ND | BLUE CROSS BLUE SHIELD |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2010. 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.