# SELBY VOLUNTEER AMBULANCE

> 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:** 1275687386
- **Authorized official:** SHARON MOAK (TREASURER)
- **Authorized official phone:** (605) 649-7362

## Contact information

- **Practice address:** 2511 3RD AVE, SELBY, SD 57472-0192
- **Practice address phone:** (605) 649-7362
- **Mailing address:** PO BOX 192, SELBY, SD 57472-0192

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 632 | SD | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 04/17/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0099140 | BLUE CROSS BLUE SHIELD | SD |
| 05 | — | 9001230 | — | SD |
| 01 | — | P00133441 | RAILROAD MEDICARE | SD |