Organization
COUNTY OF MOODY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE SMITH (ACCOUT REPRESENTATIVE)
(877) 882-9911
Entity
Organization
Contact information
Practice address
108 E PIPESTONE AVE STE B, FLANDREAU, SD 57028-1759
(877) 882-9911
(877) 882-9922
Mailing address
108 E PIPESTONE AVE STE B, FLANDREAU, SD 57028-1759
(877) 882-9911
(877) 882-9922
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
521
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9010260
—
SD
Enumeration date
07/02/2006
Last updated
10/26/2007
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