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Organization
LEOLA AMBULANCE
Active
Organization
LEOLA AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE SMITH (ACCOUNT MANAGER)
(605) 793-9911
Entity
Organization
Contact information
Practice address
1208 MAIN ST, LEOLA, SD 57456-0226
(605) 439-3314
Mailing address
1208 MAIN ST, LEOLA, SD 57456-0000
(605) 439-3314
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0472
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0099078
WELLMARK
SD
05
—
9011300
—
SD
Enumeration date
04/23/2012
Last updated
10/17/2013
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