# COUNTY OF JERAULD

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

## Provider details

- **NPI number:** 1538149455
- **Authorized official:** MRS. SHANNON FAGERHAUG (JERAULD COUNTY AUDITOR)
- **Authorized official phone:** (605) 539-9301

## Contact information

- **Practice address:** 604 1ST ST NE, WESSINGTON SPRINGS, SD 57382-2166
- **Practice address phone:** (605) 539-1201
- **Practice address fax:** (605) 539-4580
- **Mailing address:** 604 1ST ST NE, WESSINGTON SPRINGS, SD 57382-2166
- **Mailing address phone:** (605) 539-1201
- **Mailing address fax:** (605) 539-4580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 01/18/2006
- **Last updated:** 11/23/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0099040 | BC BS | SD |
| 05 | — | 9000530 | — | SD |
| 01 | — | S99040 | MEDICARE PROVIDER\# | SD |