Provider Demographics
NPI:1609189950
Name:ALCESTER EMS
Entity Type:Organization
Organization Name:ALCESTER EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:A
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-934-2338
Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:ALCESTER
Mailing Address - State:SD
Mailing Address - Zip Code:57001-0911
Mailing Address - Country:US
Mailing Address - Phone:605-934-2338
Mailing Address - Fax:
Practice Address - Street 1:106 W 2ND STREET
Practice Address - Street 2:
Practice Address - City:ALCESTER
Practice Address - State:SD
Practice Address - Zip Code:57001
Practice Address - Country:US
Practice Address - Phone:605-934-2338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD06243416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1609189950OtherWELLMARK, BCBS
SD9017070Medicaid
SDS104151Medicare PIN