Healthcare Provider Details

I. General information

NPI: 1568205805
Provider Name (Legal Business Name): RURAL OFFICE OF COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 06/14/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 SOUTH MAIN AVE
WAGNER SD
57380
US

IV. Provider business mailing address

PO BOX 547
WAGNER SD
57380
US

V. Phone/Fax

Practice location:
  • Phone: 605-630-9847
  • Fax:
Mailing address:
  • Phone: 605-384-3883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: PETER SMITH
Title or Position: CEO
Credential:
Phone: 605-481-8223