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Organization
MCINTOSH VOLUNTEER FIRE DEPARTMENT AMBULANCE SERVICE, INC.
Active
Organization
MCINTOSH VOLUNTEER FIRE DEPARTMENT AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE OR GARY BUBBERS (CAPTAIN)
(605) 273-4469
Entity
Organization
Contact information
Practice address
120 1ST AVE E, MC INTOSH, SD 57641-0174
(605) 273-4210
Mailing address
PO BOX 174, 120 1ST AVE. EAST, MC INTOSH, SD 57641-0174
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0201
SD
3416L0300X
Land Ambulance
80
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0099232
WELLMARK
SD
05
—
9001170
—
SD
Enumeration date
05/23/2007
Last updated
11/07/2008
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