Organization
CENTERVILLE COMMUNITY AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA A PETERSEN (SECRETARY - TREASURER/BILLING MANGR)
(605) 563-2842
Entity
Organization
Contact information
Practice address
800 MAIN STREET, BOX 181, CENTERVILLE, SD 57014-0181
(605) 563-2842
(605) 563-2804
Mailing address
PO BOX 181, 800 MAIN, CENTERVILLE, SD 57014-0181
(605) 563-2842
(605) 563-2804
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
611
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4305151
BLUE CROSS BLUE SHIELD
—
05
—
9000490
—
SD
01
—
9214848
DAKOTACARE
—
01
—
93812
HEALTH PARTNERS
—
Enumeration date
07/26/2005
Last updated
08/22/2020
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