Organization Name: | WHITE LAKE AMBULANCE SERVICE |
NPI Number: | 1417175373 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAROL SCHROEDER (SECRETARY) |
Mailing Address: | 209 North Main Street White Lake |
State: | SD US |
Postal Code: | 573830245 |
Phone Number: | 6052492279 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2007 |
NPI Last Update Date: | 04/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416L0300X |
License Number: | 102 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Land Transport |
Taxonomy Definition: |