| Organization Name: | LEOLA AMBULANCE |
| NPI Number: | 1326079971 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELE SMITH (ACCOUNT REPRESENTATIVE) |
| Mailing Address: | 1208 Main St Leola |
| State: | SD US |
| Postal Code: | 57456 |
| Phone Number: | 8778829911 |
| Fax Number: | 8778829922 |
| NPI Enumeration Date: | 07/05/2006 |
| NPI Last Update Date: | 01/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 472 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |