Provider Demographics
NPI:1619201142
Name:CARTHAGE AMBULANCE SERVICE
Entity Type:Organization
Organization Name:CARTHAGE AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTOFFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGERKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-772-2265
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:SD
Mailing Address - Zip Code:57323-0084
Mailing Address - Country:US
Mailing Address - Phone:605-772-2265
Mailing Address - Fax:605-772-2265
Practice Address - Street 1:110 MAIN ST W
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:SD
Practice Address - Zip Code:57323-2100
Practice Address - Country:US
Practice Address - Phone:605-772-4173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD05113416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport