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General NPI Number Information
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NPI Number | 1134210180
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Entity Type | Organization
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Legal Business Name | MISSOURI VALLEY AMBULANCE SERVICE
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 306 N. COURTLAND ST.
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City | CHAMBERLAIN
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State | SD
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Zip | 57325
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Country | US
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Telephone | 605-234-4490
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Fax | 605-234-4491
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Provider Business Mailing Address
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Address Line | PO BOX 354
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City | CHAMBERLAIN
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State | SD
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Zip | 57325-0354
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Country | US
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Telephone | 605-234-4490
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Fax |
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Authorized Official
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Title or Position | AMBULANCE DIRECTOR
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Name | KATHERYN Q. BENTON
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Credential |
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Telephone | 605-234-4490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 0131
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License Number State | SD
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