Provider Demographics
NPI:1093239931
Name:FM AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:FM AMBULANCE SERVICE, INC
Other - Org Name:SANFORD AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR EXECUTIVE DIRECTOR REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-328-8384
Mailing Address - Street 1:2215 18TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5105
Mailing Address - Country:US
Mailing Address - Phone:701-364-1700
Mailing Address - Fax:701-364-1705
Practice Address - Street 1:2215 18TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5105
Practice Address - Country:US
Practice Address - Phone:701-364-1700
Practice Address - Fax:701-364-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)