Provider Demographics
NPI:1952706053
Name:PRECISION PARAMEDIC SERVICES INC
Entity Type:Organization
Organization Name:PRECISION PARAMEDIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BENJI
Authorized Official - Middle Name:
Authorized Official - Last Name:KITAGAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:308-660-9321
Mailing Address - Street 1:105 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:MANDAREE
Mailing Address - State:ND
Mailing Address - Zip Code:58757
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:MANDAREE
Practice Address - State:ND
Practice Address - Zip Code:58757
Practice Address - Country:US
Practice Address - Phone:308-660-9321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1493416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND56850Medicaid
NDN720763Medicare PIN