Spring Grove Ambulance Corporation
Organization Active NPI Land Ambulance · Spring Grove, MN
NPI 1881764041 · NPPES record last updated May 9, 2024
Key facts
- NPI
- 1881764041
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- SPRING GROVE AMBULANCE CORPORATION
- Practice address
- 192 W Main St
Spring Grove, MN 55974-1444 - Phone
- (507) 498-3098
- NPI assigned
- Nov 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Heather M Gray
- Title
- Treasurer
- Phone
- (507) 459-1948
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090616000746 | MN | Part B Supplier - Ambulance Service Supplier | 9931259777 | Practice locations: Spring Grove, MN |
National Provider Directory
Locations
172 W Main St
Ste 101
Spring Grove, MN 55974
Phone (507) 498-3098
192 W Main St
Spring Grove, MN 55974
Phone (507) 498-3098
118 1st Ave NW
Spring Grove, MN 55974
Phone (507) 498-5221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
192 W Main St
Spring Grove, MN 55974-1444
Mailing address
PO Box 122
Spring Grove, MN 55974-0122
Phone (507) 498-3098
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39737SP | Other | MN | BLUE PLUS |
| 39737SP | Other | MN | BCBS |
| 761367900 | Other | MN | MHCP |
Other names
- Spring Grove Ambulance Service
Other providers in Spring Grove, MN
- Gundersen Clinic LTD
- Independent School District #297
- Rushford Drug Company
- Charity Lyn Schroeder
- Amanda Rae Schuttemeier
- Spring Grove Assisted Living LLC
- Spring Grove Family Chiropractic, PA
- The Reflective Haven LLC
- Molly E Thomas
- Gregory N Tjossem
All providers in Spring Grove, MN · Land Ambulance in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.