Provider Demographics
NPI:1174601561
Name:GRAND MEADOW AREA AMBULANCE SERVICE
Entity type:Organization
Organization Name:GRAND MEADOW AREA AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAMP
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:507-754-5908
Mailing Address - Street 1:200 2 ST SE
Mailing Address - Street 2:P.O. BOX 1027
Mailing Address - City:GRAND MEADOW
Mailing Address - State:MN
Mailing Address - Zip Code:55936-1027
Mailing Address - Country:US
Mailing Address - Phone:507-754-5150
Mailing Address - Fax:507-754-6150
Practice Address - Street 1:200 SE 2 ST
Practice Address - Street 2:
Practice Address - City:GRAND MEADOW
Practice Address - State:MN
Practice Address - Zip Code:55936-1027
Practice Address - Country:US
Practice Address - Phone:507-754-5150
Practice Address - Fax:507-754-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00963416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN32115GROtherBLUE CROSS