# KEYSTONE AMBULANCE SERVICE INC.

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

## Provider details

- **NPI number:** 1437120359
- **Authorized official:** MRS. DEANA MARIE MULLOY III (OFFICE MANAGER)
- **Authorized official phone:** (605) 666-5033

## Contact information

- **Practice address:** 1005 HARNEY STREET, BOX 175, KEYSTONE, SD 57751-0175
- **Practice address phone:** (605) 666-5033
- **Practice address fax:** (605) 666-5236
- **Mailing address:** BOX 175, 1005 HARNEY STREET, KEYSTONE, SD 57751-0175
- **Mailing address phone:** (605) 666-5033
- **Mailing address fax:** (605) 666-5236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 025 | SD | Yes |

## Other

- **Enumeration date:** 01/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9002930 | — | SD |