Provider Demographics
NPI:1154511962
Name:OST AMBULANCE SERVICE
Entity Type:Organization
Organization Name:OST AMBULANCE SERVICE
Other - Org Name:OGLALA SIOUX TRIBE AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:OST AMBULANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLOW BOY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:058-671-3516
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:PINE RIDGE
Mailing Address - State:SD
Mailing Address - Zip Code:57770-0346
Mailing Address - Country:US
Mailing Address - Phone:605-867-1351
Mailing Address - Fax:605-867-5706
Practice Address - Street 1:OLD IHS HOSPITAL
Practice Address - Street 2:
Practice Address - City:PINE RIDGE
Practice Address - State:SD
Practice Address - Zip Code:57770
Practice Address - Country:US
Practice Address - Phone:605-867-1351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9017080Medicaid
SDS3133Medicare PIN