Provider Demographics
NPI:1164594479
Name:CITY OF CARSON/CARSON AMBULANCE SERVICE
Entity Type:Organization
Organization Name:CITY OF CARSON/CARSON AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY AUDITOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPRENGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-622-3395
Mailing Address - Street 1:100 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:ND
Mailing Address - Zip Code:58529-4002
Mailing Address - Country:US
Mailing Address - Phone:701-622-3395
Mailing Address - Fax:701-622-3909
Practice Address - Street 1:100 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:ND
Practice Address - Zip Code:58529-4002
Practice Address - Country:US
Practice Address - Phone:701-622-3395
Practice Address - Fax:701-622-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND0223416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1897001OtherBLUE CROSS BLUE SHIELD
ND57827Medicaid
ND57827Medicaid