Healthcare Provider Details

I. General information

NPI: 1154476810
Provider Name (Legal Business Name): SESDAC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E CHERRY ST
VERMILLION SD
57069-1606
US

IV. Provider business mailing address

1314 E CHERRY ST
VERMILLION SD
57069-1606
US

V. Phone/Fax

Practice location:
  • Phone: 605-624-4419
  • Fax: 605-624-7375
Mailing address:
  • Phone: 605-624-4419
  • Fax: 605-624-7375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: LINDA M PAULSON
Title or Position: BUSINESS MANAGER
Credential:
Phone: 605-624-4419