Organization
CITY AUDITOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE SMITH (ACCOUNT REPRESENTATIVE)
(877) 882-9911
Entity
Organization
Contact information
Practice address
115 N MAIN AVE, PARKER, SD 57053-0265
(605) 297-4453
(605) 297-2149
Mailing address
PO BOX 265, PARKER, SD 57053-0265
(605) 297-4453
(605) 297-2149
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
614-01
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000670
—
SD
Enumeration date
10/15/2007
Last updated
04/27/2010
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