Provider Demographics
NPI:1790907251
Name:CITY OF NASHWAUK
Entity Type:Organization
Organization Name:CITY OF NASHWAUK
Other - Org Name:NASHWAUK AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALIGURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-312-3002
Mailing Address - Street 1:1200 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3897
Mailing Address - Country:US
Mailing Address - Phone:218-312-3002
Mailing Address - Fax:218-312-3003
Practice Address - Street 1:301 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:NASHWAUK
Practice Address - State:MN
Practice Address - Zip Code:55769-1131
Practice Address - Country:US
Practice Address - Phone:218-312-3002
Practice Address - Fax:218-312-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN590014445OtherRAILROAD MEDICARE
MN120025OtherUCARE
MN053435800Medicaid
MN72503NAOtherBLUE SHIELD
MN590000055Medicare PIN