Provider Demographics
NPI:1134469521
Name:HURLEY VOLUNTEER FIRE DEPARTMENT & AMBULANCE
Entity Type:Organization
Organization Name:HURLEY VOLUNTEER FIRE DEPARTMENT & AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-238-5888
Mailing Address - Street 1:311 MAIN
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:SD
Mailing Address - Zip Code:57036-0000
Mailing Address - Country:US
Mailing Address - Phone:605-238-5888
Mailing Address - Fax:605-238-5888
Practice Address - Street 1:311 MAIN
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:SD
Practice Address - Zip Code:57036
Practice Address - Country:US
Practice Address - Phone:605-238-5888
Practice Address - Fax:605-238-5888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD06123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0612OtherSD EMS