Provider Demographics
NPI:1447417217
Name:ELY AREA AMBULANCE SERVICE
Entity Type:Organization
Organization Name:ELY AREA AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE AMBULANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GALASKI
Authorized Official - Suffix:
Authorized Official - Credentials:EMTP
Authorized Official - Phone:218-365-6322
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:MN
Mailing Address - Zip Code:55731
Mailing Address - Country:US
Mailing Address - Phone:218-365-6322
Mailing Address - Fax:
Practice Address - Street 1:328 W CONAN ST
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:MN
Practice Address - Zip Code:55731-1145
Practice Address - Country:US
Practice Address - Phone:218-365-3271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport