Organization
WAGNER-LAKE ANDES AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. B STEINMARK (ADMINISTRATOR)
(605) 487-6177
Entity
Organization
Contact information
Practice address
455 E MAIN ST., LAKE ANDES, SD 57356-0758
(605) 487-6177
(605) 487-6177
Mailing address
PO BOX 758, LAKE ANDES, SD 57356-0758
(605) 487-6177
(605) 487-6177
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0171 AND 0173
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0735183
—
IA
01
—
4997455
BLUE CROSS BLUE SHIELD
—
05
—
9000510
—
SD
05
—
QAB175
—
SC
Enumeration date
07/13/2006
Last updated
04/20/2008
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