# NORTHEAST AMBULANCE SERVICE

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

## Provider details

- **NPI number:** 1164470852
- **Authorized official:** JANET Y GRIEPP (MEDICAL BILLING)
- **Authorized official phone:** (605) 698-3797

## Contact information

- **Practice address:** 105 N TEDIN AVE, ROSHOLT, SD 57260-2106
- **Practice address phone:** (605) 537-4215
- **Mailing address:** 45294 116TH ST, SISSETON, SD 57262-6909
- **Mailing address phone:** (605) 698-3797
- **Mailing address fax:** (605) 698-9061

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 0551 | SD | Yes |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0099167 | OTHER PROVIDER NUMBER | SD |
| 05 | — | 9001420 | — | SD |