1013139583 NPI number — CITY OF HIBBING

Table of content: (NPI 1013139583)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013139583 NPI number — CITY OF HIBBING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF HIBBING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HIBBING AMBULANCE SERVICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013139583
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 E 21ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIBBING
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55746-5510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-312-1602
Provider Business Mailing Address Fax Number:
218-403-5706

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2320 BROOKLYN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIBBING
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55746-1955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-312-3002
Provider Business Practice Location Address Fax Number:
218-312-3003
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MULNER
Authorized Official First Name:
SHEENA
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCE DIRECTOR/TREASURER
Authorized Official Telephone Number:
218-312-1602

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 112096 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 69331HI . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 590656409 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 232767800 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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