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General NPI Number Information
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NPI Number | 1619201142
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Entity Type | Organization
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Legal Business Name | CARTHAGE AMBULANCE SERVICE
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 02/15/2019
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Provider Practice Location Address
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Address Line | 110 MAIN ST W
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City | CARTHAGE
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State | SD
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Zip | 57323-2100
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Country | US
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Telephone | 605-772-4173
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 84
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City | CARTHAGE
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State | SD
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Zip | 57323-0084
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Country | US
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Telephone | 605-772-2265
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Fax | 605-772-2265
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Authorized Official
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Title or Position | DIRECTOR
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Name | KRISTOFFER MAGERKO
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Credential |
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Telephone | 605-772-2265
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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 | 0511
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License Number State | SD
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