Healthcare Provider Details
I. General information
NPI: 1275956948
Provider Name (Legal Business Name): BLACK HILLS TRANSIT INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2014
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
436 E COLORADO BLVD
SPEARFISH SD
57783-2769
US
IV. Provider business mailing address
135 E COLORADO BLVD
SPEARFISH SD
57783-2755
US
V. Phone/Fax
- Phone: 605-642-2250
- Fax:
- Phone: 605-642-2250
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343800000X |
| Taxonomy | Secured Medical Transport (VAN) |
| License Number | |
| License Number State | SD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | SD |
VIII. Authorized Official
Name:
BARBARA
K
CLINE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 605-642-2250