Provider Demographics
NPI:1073673414
Name:NEW ENGLAND AMBULANCE SERVICE
Entity Type:Organization
Organization Name:NEW ENGLAND AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-579-4376
Mailing Address - Street 1:5848 HIGHWAY 22 S
Mailing Address - Street 2:
Mailing Address - City:NEW ENGLAND
Mailing Address - State:ND
Mailing Address - Zip Code:58647-9103
Mailing Address - Country:US
Mailing Address - Phone:218-233-5658
Mailing Address - Fax:218-233-7630
Practice Address - Street 1:5848 HIGHWAY 22 S
Practice Address - Street 2:
Practice Address - City:NEW ENGLAND
Practice Address - State:ND
Practice Address - Zip Code:58647-9103
Practice Address - Country:US
Practice Address - Phone:218-233-5658
Practice Address - Fax:218-233-7630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND933416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND7019OtherBLUE CROSS BLUE SHIELD
ND52409Medicaid
NDN7019Medicare PIN