Provider Demographics
NPI:1578889523
Name:BURKE AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:BURKE AMBULANCE SERVICE INC
Other - Org Name:BURKE AMBULANCE SERVICE, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-830-2221
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:701 WASHINGTON STREET
Mailing Address - City:BURKE
Mailing Address - State:SD
Mailing Address - Zip Code:57523-0061
Mailing Address - Country:US
Mailing Address - Phone:605-775-9055
Mailing Address - Fax:605-775-9055
Practice Address - Street 1:701 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:SD
Practice Address - Zip Code:57523-0061
Practice Address - Country:US
Practice Address - Phone:605-830-2221
Practice Address - Fax:605-775-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD03023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport