Provider Demographics
NPI:1093729428
Name:CITY OF MEADOWLANDS
Entity Type:Organization
Organization Name:CITY OF MEADOWLANDS
Other - Org Name:MEADOWLANDS AMBULANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:MAYOR OF MEADOWLANDS
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:TARAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-427-2577
Mailing Address - Street 1:3920 13TH AVE E
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3675
Mailing Address - Country:US
Mailing Address - Phone:218-263-7540
Mailing Address - Fax:866-732-0699
Practice Address - Street 1:9955 HWY. 133
Practice Address - Street 2:
Practice Address - City:MEADOWLANDS
Practice Address - State:MN
Practice Address - Zip Code:55765-0146
Practice Address - Country:US
Practice Address - Phone:218-427-2236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN72368MEOtherBCBS
MNP00128286Medicare PIN