Provider Demographics
NPI:1124100524
Name:WESTHOPE AMBULANCE SERVICE
Entity type:Organization
Organization Name:WESTHOPE AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHEPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-245-6571
Mailing Address - Street 1:RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTHOPE
Mailing Address - State:ND
Mailing Address - Zip Code:58793-0214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:WESTHOPE
Practice Address - State:ND
Practice Address - Zip Code:58793-0214
Practice Address - Country:US
Practice Address - Phone:701-245-6409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND130341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND52602Medicaid
ND7017OtherBLUE CROSS BLUE SHIELD
NDN7017Medicare ID - Type Unspecified