Provider Demographics
NPI:1932269750
Name:CITY OF BARNESVILLE
Entity Type:Organization
Organization Name:CITY OF BARNESVILLE
Other - Org Name:BARNESVILLE AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-354-2292
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56514-0550
Mailing Address - Country:US
Mailing Address - Phone:218-354-2292
Mailing Address - Fax:218-354-2472
Practice Address - Street 1:101 2ND AVE NW
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:MN
Practice Address - Zip Code:56514
Practice Address - Country:US
Practice Address - Phone:218-354-2299
Practice Address - Fax:218-354-2472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN18303416L0300X
MN00193416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN252567400Medicaid
MN61116BAOtherBLUE CROSS BLUE SHIELD
MN599000006Medicare ID - Type Unspecified