Provider Demographics
NPI:1730282062
Name:CITY OF ALTURA
Entity Type:Organization
Organization Name:CITY OF ALTURA
Other - Org Name:ALTURA AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-208-9801
Mailing Address - Street 1:25 NORTH MAIN
Mailing Address - Street 2:P. O. BOX 36
Mailing Address - City:ALTURA
Mailing Address - State:MN
Mailing Address - Zip Code:55910
Mailing Address - Country:US
Mailing Address - Phone:507-251-6351
Mailing Address - Fax:507-796-9192
Practice Address - Street 1:25 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:ALTURA
Practice Address - State:MN
Practice Address - Zip Code:55910
Practice Address - Country:US
Practice Address - Phone:507-251-6351
Practice Address - Fax:507-796-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0007146N00000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty