MEDICARE: ELK POINT COMMUNITY AMBULANCE SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	622	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306877980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELK POINT COMMUNITY AMBULANCE SERVICE

Provider Business Mailing Address
First Line	:	210 E MAIN ST
Second Line	:
City	:	ELK POINT
State	:	SD
Zip	:	57025
Country	:	US
Telephone Number	:	877-882-9911
Fax Number	:	877-882-9922

Provider Business Practice Location Address
First Line	:	210 E MAIN ST
Second Line	:
City	:	ELK POINT
State	:	SD
Zip	:	57025
Country	:	US
Telephone Number	:	877-882-9911
Fax Number	:	877-882-9922

Authorized Official
Title or Position	:	ACCOUNT REPRESENTATIVE
Name	:	MRS. MICHELE SMITH
Credential	:
Telephone Number	:	877-882-9911

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	10/26/2007

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Directions to “ELK POINT COMMUNITY AMBULANCE SERVICE ” Practice Location

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