Provider Demographics
NPI:1124118583
Name:SARGENT CO AMBULANCE OF MILNOR
Entity type:Organization
Organization Name:SARGENT CO AMBULANCE OF MILNOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:TAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-427-5333
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:MILNOR
Mailing Address - State:ND
Mailing Address - Zip Code:58060-0098
Mailing Address - Country:US
Mailing Address - Phone:701-427-5333
Mailing Address - Fax:
Practice Address - Street 1:323 MAIN ST.
Practice Address - Street 2:
Practice Address - City:MILNOR
Practice Address - State:ND
Practice Address - Zip Code:58060-0098
Practice Address - Country:US
Practice Address - Phone:701-427-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND86341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND7120OtherBLUE CROSS
ND56350Medicaid
ND590003795Medicare ID - Type UnspecifiedRAILROAD
ND56350Medicaid