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Organization
SELBY VOLUNTEER AMBULANCE
Active
Organization
SELBY VOLUNTEER AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON MOAK (TREASURER)
(605) 649-7362
Entity
Organization
Contact information
Practice address
2511 3RD AVE, SELBY, SD 57472-0192
(605) 649-7362
Mailing address
PO BOX 192, SELBY, SD 57472-0192
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
632
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0099140
BLUE CROSS BLUE SHIELD
SD
05
—
9001230
—
SD
01
—
P00133441
RAILROAD MEDICARE
SD
Enumeration date
01/23/2007
Last updated
04/17/2013
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