Provider Demographics
NPI:1528213329
Name:CITY OF ESTELLINE
Entity Type:Organization
Organization Name:CITY OF ESTELLINE
Other - Org Name:ESTELLINE AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAATHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-873-2388
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:ESTELLINE
Mailing Address - State:SD
Mailing Address - Zip Code:57234-0278
Mailing Address - Country:US
Mailing Address - Phone:605-873-2388
Mailing Address - Fax:605-873-2394
Practice Address - Street 1:117 MAIN ST.
Practice Address - Street 2:
Practice Address - City:ESTELLINE
Practice Address - State:SD
Practice Address - Zip Code:57234-0278
Practice Address - Country:US
Practice Address - Phone:605-873-2388
Practice Address - Fax:605-873-2394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0322-01341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS99066Medicare PIN