# JEFFERSON 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:** 1992734818
- **Authorized official:** MRS. MICHELE SMITH (BILLING MANAGER)
- **Authorized official phone:** (877) 882-9911

## Contact information

- **Practice address:** 509 RAILROAD ST, JEFFERSON, SD 57038
- **Practice address phone:** (877) 882-9911
- **Practice address fax:** (877) 882-9922
- **Mailing address:** 509 RAILROAD STREET, JEFFERSON, SD 57038
- **Mailing address phone:** (877) 882-9911
- **Mailing address fax:** (877) 882-9922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 623 | SD | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 10/03/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1992734818 | WELLMARK, BCBS | SD |
| 05 | — | 9001090 | — | SD |