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General NPI Number Information
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NPI Number | 1821276379
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Entity Type | Organization
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Legal Business Name | NEW UNDERWOOD AMBULANCE SERVICE
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 314 S 'A' AVE
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City | NEW UNDERWOOD
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State | SD
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Zip | 57761-0436
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Country | US
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Telephone | 605-754-6405
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 436
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City | NEW UNDERWOOD
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State | SD
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Zip | 57761-0436
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Country | US
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Telephone | 605-754-6405
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | LAURIE HOLLOWAY
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Credential |
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Telephone | 605-754-6405
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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 | 023
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License Number State | SD
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