Provider Demographics
NPI:1871662833
Name:JONES COUNTY EMERGENCY CARE COUNCIL, INC
Entity Type:Organization
Organization Name:JONES COUNTY EMERGENCY CARE COUNCIL, INC
Other - Org Name:JONES COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:JADE
Authorized Official - Last Name:NEWBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-669-3125
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:MURDO
Mailing Address - State:SD
Mailing Address - Zip Code:57559-0305
Mailing Address - Country:US
Mailing Address - Phone:605-669-3125
Mailing Address - Fax:605-669-2841
Practice Address - Street 1:101 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:MURDO
Practice Address - State:SD
Practice Address - Zip Code:57559
Practice Address - Country:US
Practice Address - Phone:605-669-3125
Practice Address - Fax:605-669-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD411341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0099155OtherBLUE CROSS/BLUE SHIELD
WY1228293Medicaid
SD9011180Medicaid
SD41051Medicare ID - Type Unspecified
WY1228293Medicaid