Organization
MCINTOSH VOLUNTEER FIRE DEPARTMENT AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE OR GARY BUBBERS (CAPTAIN)
(605) 273-4469
Entity
Organization
Contact information
Practice address
120 1ST AVE E, MC INTOSH, SD 57641-0174
(605) 273-4210
Mailing address
PO BOX 174, 120 1ST AVE. EAST, MC INTOSH, SD 57641-0174
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0201
SD
3416L0300X
Land Ambulance
80
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0099232
WELLMARK
SD
05
—
9001170
—
SD
Enumeration date
05/23/2007
Last updated
11/07/2008
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