MADDOCK AMBULANCE SERVICE (NPI# 1760539100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760539100 |
| Entity Type | Organization |
| Organization Name | MADDOCK AMBULANCE SERVICE |
| Practice Address |
206 Lincoln Ave Maddock ND 58348-0208 |
| Mailing Address |
Po Box 208 Maddock ND 58348-0208 |
| Practice Telephone | 7014382319 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2009-10-21 |
| Authorized Official Name | JOYCE RASMUSSEN (SECRETARY TREASURER) |
| Authorized Official Telephone | 7014382319 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
074 | ND | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 50942 | 05 | |
| ND | BLUE CROSS BLUE SHIELD | 7189 | 01 |
| ND | RAILROAD MEDICARE | P00075504 | 01 |
| Street Address |
206 LINCOLN AVE |
| City | MADDOCK |
| State | ND |
| Zip Code | 58348-0208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548759806 | Samantha Mccloud | Speech-Language Pathologist | 909 1st Street, Maddock, ND 58348 | 2018-05-02 |
| 1073982484 | Benson County Dba Benson County Transportation | Non-emergency Medical Transport (VAN) | 105 Central Ave, Suite 201, Maddock, ND 58348 | 2015-09-16 |
| 1013015841 | Linda H Elllingson | Physician Assistant | 301 Roosevelt Ave, Maddock, ND 58348-7138 | 2006-09-20 |
| 1437573037 | Memorial Hospital Association | Assisted Living Facility | 301 Roosevelt Ave, Maddock, ND 58348-7138 | 2014-02-18 |
| 1740451038 | Good Samaritan Hospital Association | Family Medicine | 301 Roosevelt Ave, Maddock, ND 58348-7138 | 2008-03-14 |
| 1205926144 | White Drug Co of Jamestown Inc | Durable Medical Equipment & Medical Supplies | 108 Central Ave N, Maddock, ND 58348-7204 | 2006-10-13 |
| 1790384469 | Mechelle Solberg | Technician | 3149 48th Ave Ne, Maddock, ND 58348-9650 | 2020-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384469 | Mechelle Solberg | Technician | 3149 48th Ave Ne, Maddock, ND 58348-9650 | 2020-10-22 |
| 1548759806 | Samantha Mccloud | Speech-Language Pathologist | 909 1st Street, Maddock, ND 58348 | 2018-05-02 |
| 1205926144 | White Drug Co of Jamestown Inc | Durable Medical Equipment & Medical Supplies | 108 Central Ave N, Maddock, ND 58348-7204 | 2006-10-13 |
| 1013015841 | Linda H Elllingson | Physician Assistant | 301 Roosevelt Ave, Maddock, ND 58348-7138 | 2006-09-20 |
| 1073982484 | Benson County Dba Benson County Transportation | Non-emergency Medical Transport (VAN) | 105 Central Ave, Suite 201, Maddock, ND 58348 | 2015-09-16 |
| 1437573037 | Memorial Hospital Association | Assisted Living Facility | 301 Roosevelt Ave, Maddock, ND 58348-7138 | 2014-02-18 |
| 1740451038 | Good Samaritan Hospital Association | Family Medicine | 301 Roosevelt Ave, Maddock, ND 58348-7138 | 2008-03-14 |
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.