Organization
EDGEMONT AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA M LITZEL BILLING OFFICER (BILLING EAS)
(605) 662-7416
Entity
Organization
Contact information
Practice address
219 2ND STREET, EDGEMONT, SD 57735
(605) 662-7977
(605) 662-7977
Mailing address
PO BOX 212, EDGEMONT, SD 57735
(605) 662-7977
(605) 662-7977
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
29
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9010800
—
SD
Enumeration date
10/26/2006
Last updated
11/04/2010
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