Provider Demographics
NPI:1922747336
Name:SIOUX EMPIRE MOBILITY SERVICES LLC
Entity Type:Organization
Organization Name:SIOUX EMPIRE MOBILITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-212-5998
Mailing Address - Street 1:1100 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57032-2317
Mailing Address - Country:US
Mailing Address - Phone:605-212-5998
Mailing Address - Fax:
Practice Address - Street 1:1100 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:SD
Practice Address - Zip Code:57032-2317
Practice Address - Country:US
Practice Address - Phone:605-212-5998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)