Provider Demographics
NPI:1326205295
Name:CITY OF RAPID CITY
Entity Type:Organization
Organization Name:CITY OF RAPID CITY
Other - Org Name:CITY OF RAPID CITY - RAPID CITY FIRE DEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ROSSUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-716-3689
Mailing Address - Street 1:10 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2832
Mailing Address - Country:US
Mailing Address - Phone:605-716-3689
Mailing Address - Fax:605-394-5145
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2832
Practice Address - Country:US
Practice Address - Phone:605-394-4180
Practice Address - Fax:605-394-5145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF RAPID CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-19
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
SD00203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4770469Medicaid
SD9011200Medicaid
MN440922000Medicaid
IA0589481Medicaid
NE100249960-00Medicaid
310193600OtherUS DEPT OF LABOR
MO806068607Medicaid
MT0056524Medicaid
NV100505512Medicaid
WY1207229-00Medicaid
SD0041055OtherBCBS OF SOUTH DAKOTA
OH2556961Medicaid
WI80449900Medicaid
P00009677OtherPALMETTO RAILROAD MEDICARE
SD0041055OtherBCBS OF SOUTH DAKOTA