Healthcare Provider Details

I. General information

NPI: 1184810046
Provider Name (Legal Business Name): CITY AUDITOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 WEST ELM ST
ARLINGTON SD
57212-0379
US

IV. Provider business mailing address

202 WEST ELM ST PO DRAWER 379
ARLINGTON SD
57212-0379
US

V. Phone/Fax

Practice location:
  • Phone: 605-983-5251
  • Fax: 605-983-5358
Mailing address:
  • Phone: 605-983-5251
  • Fax: 604-983-5358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0421
License Number StateSD

VIII. Authorized Official

Name: JODIE KAY HENRY
Title or Position: FO ASSISTANT
Credential:
Phone: 605-983-5251