City of Raymond
Organization Active NPI Land Ambulance · Raymond, MN
NPI 1891907697 · NPPES record last updated Mar 14, 2013
Key facts
- NPI
- 1891907697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- CITY OF RAYMOND
- Practice address
- 314 Spicer Street
Raymond, MN 56282-9998 - Phone
- (320) 967-4226
- NPI assigned
- May 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Diane Tallackson
- Title
- Claims Manager
- Phone
- (651) 653-2201
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130301000126 | MN | Part B Supplier - Ambulance Service Supplier | 1951556695 | Practice locations: Raymond, MN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | MN | Yes |
Addresses
Primary practice location
314 Spicer Street
Raymond, MN 56282-9998
Mailing address
PO Box 216
Raymond, MN 56282-0216
Phone (651) 653-2201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BCBS | Other | MN | 45656RA |
| 986313300 | Medicaid | MN |
Other names
- Raymond Ambulance Service
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2013. 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.