Provider Demographics
NPI:1386660843
Name:MERCER COUNTY AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:MERCER COUNTY AMBULANCE SERVICE INC
Other - Org Name:MERCER COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STEFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-748-7241
Mailing Address - Street 1:801 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:HAZEN
Mailing Address - State:ND
Mailing Address - Zip Code:58545-4653
Mailing Address - Country:US
Mailing Address - Phone:701-748-7283
Mailing Address - Fax:701-748-5559
Practice Address - Street 1:801 4TH ST NE
Practice Address - Street 2:
Practice Address - City:HAZEN
Practice Address - State:ND
Practice Address - Zip Code:58545-4653
Practice Address - Country:US
Practice Address - Phone:701-748-7283
Practice Address - Fax:701-748-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulanceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND7287OtherBLUE CROSS OF N DAKOTA
ND51427Medicaid
ND7287OtherBLUE CROSS OF N DAKOTA