Provider Demographics
NPI:1124175864
Name:CITY OF EDMORE
Entity type:Organization
Organization Name:CITY OF EDMORE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-644-2204
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:303 8TH AVE S
Mailing Address - City:EDMORE
Mailing Address - State:ND
Mailing Address - Zip Code:58330-0006
Mailing Address - Country:US
Mailing Address - Phone:701-644-2204
Mailing Address - Fax:701-644-2218
Practice Address - Street 1:303 8TH AVE S
Practice Address - Street 2:
Practice Address - City:EDMORE
Practice Address - State:ND
Practice Address - Zip Code:58330-0006
Practice Address - Country:US
Practice Address - Phone:701-644-2204
Practice Address - Fax:701-644-2218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND0323416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport