Tioga Fire Department
Organization Active NPI Land Ambulance · Tioga, ND
NPI 1801896162 · NPPES record last updated Oct 27, 2022
Key facts
- NPI
- 1801896162
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 118 (ND)
- Legal business name
- TIOGA FIRE DEPARTMENT
- Practice address
- 11 N. Welo St
Tioga, ND 58852-0451 - Phone
- (701) 664-5757
- Fax
- (701) 664-3424
- NPI assigned
- Jul 28, 2005
- Organization subpart
- No
Authorized official
- Name
- Randall K. Pederson
- Title
- Treasurer
- Phone
- (701) 664-5757
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D1011616 | Tioga Ambulance Service | Certificate of waiver | Apr 15, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071120000496 | ND | Part B Supplier - Ambulance Service Supplier | 6204924582 | Practice locations: Tioga, ND |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 118 | ND | Yes |
| Land Ambulance | 3416L0300X |
Addresses
Primary practice location
11 N. Welo St
Tioga, ND 58852-0451
Mailing address
PO Box 451
Tioga, ND 58852-0451
Phone (701) 664-3305
Other practice location 1
12 E Front St
Tioga, ND 58852-7311
Phone (701) 664-3305
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007059 | Other | ND | BLUE SHIELD OF ND |
| 56117 | Medicaid | ND | |
| ========= | Other | ND | ND WORKFORCE SAFETY & INS |
Other names
- Tioga Fire Department/Ambulance Service
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tiogafire@nccray.com |
Other providers in Tioga, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2022. 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.