# CENTERVILLE COMMUNITY AMBULANCE SERVICE, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134129836
- **Authorized official:** DEBRA A PETERSEN (SECRETARY - TREASURER/BILLING MANGR)
- **Authorized official phone:** (605) 563-2842

## Contact information

- **Practice address:** 800 MAIN STREET, BOX 181, CENTERVILLE, SD 57014-0181
- **Practice address phone:** (605) 563-2842
- **Practice address fax:** (605) 563-2804
- **Mailing address:** PO BOX 181, 800 MAIN, CENTERVILLE, SD 57014-0181
- **Mailing address phone:** (605) 563-2842
- **Mailing address fax:** (605) 563-2804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 611 | SD | Yes |

## Other

- **Enumeration date:** 07/26/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4305151 | BLUE CROSS BLUE SHIELD | — |
| 05 | — | 9000490 | — | SD |
| 01 | — | 9214848 | DAKOTACARE | — |
| 01 | — | 93812 | HEALTH PARTNERS | — |