Healthcare Provider Details

I. General information

NPI: 1366654345
Provider Name (Legal Business Name): TRIPP AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 10/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S MAIN ST
TRIPP SD
57376-0466
US

IV. Provider business mailing address

PO BOX P
TRIPP SD
57376-0466
US

V. Phone/Fax

Practice location:
  • Phone: 605-935-6907
  • Fax: 605-935-6331
Mailing address:
  • Phone: 605-935-6907
  • Fax: 605-935-6331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0374
License Number StateSD

VIII. Authorized Official

Name: MS. JENNIFER LYNN FRIEDERICH
Title or Position: FINANCE MANAGER
Credential:
Phone: 605-935-6907