Provider Demographics
NPI:1083807804
Name:DUPREE VOL. FIRE DEPARTMENT, INC.
Entity Type:Organization
Organization Name:DUPREE VOL. FIRE DEPARTMENT, INC.
Other - Org Name:DUPREE VOL. FIRE AND AMBULANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:CAPT.
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:605-365-7430
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:100 MAIN STREET
Mailing Address - City:DUPREE
Mailing Address - State:SD
Mailing Address - Zip Code:57623-0461
Mailing Address - Country:US
Mailing Address - Phone:605-365-5177
Mailing Address - Fax:605-365-5204
Practice Address - Street 1:100 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DUPREE
Practice Address - State:SD
Practice Address - Zip Code:57623-9998
Practice Address - Country:US
Practice Address - Phone:605-365-5177
Practice Address - Fax:605-365-5204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD671-013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9011020Medicaid
SD5477Medicare PIN