Glen Ullin Ambulance Service

Primary specialty

AmbulanceTaxonomy code 341600000X

License

44 Issued in ND

Legal business name

GLEN ULLIN AMBULANCE SERVICE

Practice address

206 2ND St South
Glen Ullin, ND 58631

Phone

(701) 348-3274

NPI assigned

Nov 15, 2006

Last updated

Sep 21, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brenda Duppong

Title

Squad Leader

Phone

(701) 348-3274

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1881766525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 974",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585540974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 2ND ST SOUTH",
            "city": "GLEN ULLIN",
            "state": "ND",
            "postal_code": "58631",
            "telephone_number": "701-348-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN ULLIN AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "DUPPONG",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "SQUAD LEADER",
        "authorized_official_telephone_number": "701-348-3274"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ND",
            "license": "44",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052187",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ND",
            "identifier": "GLE7178",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Dewees, CNA
• Linda Duppong, PA-C
• Sara Farrell, PT, DPT, CLT
• Lasheva M Gallant
• Suzanne Renae Gartner
• Glen Ullin Family Medical Center
• Glen Ullin Pharmacy LLC (Glen Ullin Pharmacy)
• Glen Ullin RHC
• Jacobson Memorial Hospital Care Center (Glen Ullin Family Medical Clinic)
• Kayla Kremers, OT

• Ambulance in Glen Ullin, ND
• Providers in Glen Ullin, ND by specialty
• Ambulance in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.