Provider Demographics
NPI:1508900697
Name:COUNTY OF MINER
Entity Type:Organization
Organization Name:COUNTY OF MINER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPRECHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-772-4671
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:SD
Mailing Address - Zip Code:57349-0086
Mailing Address - Country:US
Mailing Address - Phone:605-772-4671
Mailing Address - Fax:605-772-4203
Practice Address - Street 1:401 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:SD
Practice Address - Zip Code:57349-0086
Practice Address - Country:US
Practice Address - Phone:605-772-4671
Practice Address - Fax:605-772-4203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF MINER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3416L0300X3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9001150Medicaid
SD9001150Medicaid