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General NPI Number Information
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NPI Number | 1518049998
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Entity Type | Organization
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Legal Business Name | LYMAN COUNTY AMBULANCE SERVICE
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 SOUTH MAIN AVE.
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City | KENNEBEC
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State | SD
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Zip | 57544-0002
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Country | US
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Telephone | 605-869-2295
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Fax | 605-869-2203
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Provider Business Mailing Address
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Address Line | PO BOX 2
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City | KENNEBEC
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State | SD
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Zip | 57544-0002
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Country | US
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Telephone | 605-869-2295
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Fax | 605-869-2203
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Authorized Official
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Title or Position | BILLING CLERK
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Name | CAROL JEAN SUNDALL
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Credential |
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Telephone | 605-869-2295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 0452
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License Number State | SD
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