Provider Demographics
NPI:1528037231
Name:CITY AUDITOR & LIGHT & WATER
Entity Type:Organization
Organization Name:CITY AUDITOR & LIGHT & WATER
Other - Org Name:CITY OF TYNDALL AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PUTNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-589-3481
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:TYNDALL
Mailing Address - State:SD
Mailing Address - Zip Code:57066-0029
Mailing Address - Country:US
Mailing Address - Phone:605-589-3481
Mailing Address - Fax:
Practice Address - Street 1:110 E. 17TH AVE.
Practice Address - Street 2:
Practice Address - City:TYNDALL
Practice Address - State:SD
Practice Address - Zip Code:57066-0029
Practice Address - Country:US
Practice Address - Phone:605-589-3481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9000550Medicaid
SD0099043OtherBLUE CROSS & BLUE SHIELD
SD9000550Medicaid