Provider Demographics
NPI:1588752331
Name:CITY OF NEW ROCKFORD
Entity type:Organization
Organization Name:CITY OF NEW ROCKFORD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SQUAD LEADER/BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-947-2989
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:NEW ROCKFORD
Mailing Address - State:ND
Mailing Address - Zip Code:58356-0246
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:117 1ST ST S
Practice Address - Street 2:
Practice Address - City:NEW ROCKFORD
Practice Address - State:ND
Practice Address - Zip Code:58356-1926
Practice Address - Country:US
Practice Address - Phone:701-947-2404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND095341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND791590360OtherRAILROAD MEDICARE
ND51349Medicaid
ND7279OtherBLUE CROSS BLUE SHIELD
ND7279OtherBLUE CROSS BLUE SHIELD