Provider Demographics
NPI:1891854212
Name:KINDRED AREA AMBULANCE SERVICE INC.
Entity Type:Organization
Organization Name:KINDRED AREA AMBULANCE SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:TORGERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-428-3801
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56561-0364
Mailing Address - Country:US
Mailing Address - Phone:218-233-5658
Mailing Address - Fax:
Practice Address - Street 1:100 1ST AVE N
Practice Address - Street 2:
Practice Address - City:KINDRED
Practice Address - State:ND
Practice Address - Zip Code:58051-0295
Practice Address - Country:US
Practice Address - Phone:701-428-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND63341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND58652Medicaid
ND7443OtherBLUE CROSS BLUE SHIELD
ND7443OtherBLUE CROSS BLUE SHIELD