| Organization Name: | GRANT-ROBERTS AMBULANCE, INC. |
| NPI Number: | 1851451207 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BARRET WICKLUND (OWNER) |
| Mailing Address: | 306 S 3rd St Milbank |
| State: | SD US |
| Postal Code: | 572521818 |
| Phone Number: | 6054326783 |
| Fax Number: | |
| NPI Enumeration Date: | 12/08/2006 |
| NPI Last Update Date: | 10/25/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 0291 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |