Healthcare Provider Details

I. General information

NPI: 1326205295
Provider Name (Legal Business Name): CITY OF RAPID CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MAIN ST
RAPID CITY SD
57701-2832
US

IV. Provider business mailing address

10 MAIN ST
RAPID CITY SD
57701-2832
US

V. Phone/Fax

Practice location:
  • Phone: 605-394-4180
  • Fax: 605-394-5145
Mailing address:
  • Phone: 605-716-3689
  • Fax: 605-394-5145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0020
License Number StateSD

VIII. Authorized Official

Name: DENISE KAY ROSSUM
Title or Position: EMS BILLING
Credential:
Phone: 605-716-3689