Provider Demographics
NPI:1841362761
Name:CITY OF WEST CONCORD
Entity type:Organization
Organization Name:CITY OF WEST CONCORD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:LA PLOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-P
Authorized Official - Phone:507-774-2583
Mailing Address - Street 1:315 W MAIN ST
Mailing Address - Street 2:P O BOX 586
Mailing Address - City:WEST CONCORD
Mailing Address - State:MN
Mailing Address - Zip Code:55985-0586
Mailing Address - Country:US
Mailing Address - Phone:507-527-2176
Mailing Address - Fax:
Practice Address - Street 1:315 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST CONCORD
Practice Address - State:MN
Practice Address - Zip Code:55985-0586
Practice Address - Country:US
Practice Address - Phone:507-527-2176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0265146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3113671Medicaid
MN0265OtherSTATE AMBULANCE LICENSE
MN3113671Medicaid