Healthcare Provider Details

I. General information

NPI: 1972640381
Provider Name (Legal Business Name): ROSEBUD SIOUX TRIBE AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CIRCLE DR
ROSEBUD SD
57570
US

IV. Provider business mailing address

15 CIRCLE DR PO BOX 200
ROSEBUD SD
57570
US

V. Phone/Fax

Practice location:
  • Phone: 605-747-2633
  • Fax:
Mailing address:
  • Phone: 605-747-2633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number601
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number601
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number601
License Number StateSD

VIII. Authorized Official

Name: C STEVE BRAVE
Title or Position: DIRECTOR
Credential:
Phone: 605-747-2633