Provider Demographics
NPI:1831288968
Name:VELVA AMBULANCE SERVICE INC.
Entity Type:Organization
Organization Name:VELVA AMBULANCE SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURE
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JUNGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-720-2793
Mailing Address - Street 1:105 1ST STREET WEST
Mailing Address - Street 2:PO BOX 231
Mailing Address - City:VELVA
Mailing Address - State:ND
Mailing Address - Zip Code:58790-0231
Mailing Address - Country:US
Mailing Address - Phone:701-338-2361
Mailing Address - Fax:
Practice Address - Street 1:105 1ST STREET WEST
Practice Address - Street 2:
Practice Address - City:VELVA
Practice Address - State:ND
Practice Address - Zip Code:58790-0231
Practice Address - Country:US
Practice Address - Phone:701-338-2361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2009-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND126341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND590010238OtherRAILROAD MEDICARE
ND7686OtherBLUE CROSS BLUE SHIELD
ND50158Medicaid
ND590010238OtherRAILROAD MEDICARE