Provider Demographics
NPI:1366499915
Name:SIOUX FALLS AMBULANCE INC
Entity Type:Organization
Organization Name:SIOUX FALLS AMBULANCE INC
Other - Org Name:RURAL/METRO AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-227-6078
Mailing Address - Street 1:PO BOX 2812
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-2812
Mailing Address - Country:US
Mailing Address - Phone:855-249-2841
Mailing Address - Fax:480-627-6128
Practice Address - Street 1:121 S WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-3135
Practice Address - Country:US
Practice Address - Phone:605-336-6711
Practice Address - Fax:605-336-1445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD00143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD590163170OtherRR MEDICARE NO
SD9010020Medicaid
SD590163170OtherRR MEDICARE NO