Provider Demographics
NPI:1972731974
Name:STANDING ROCK PUBLIC TRANSPORTATION
Entity Type:Organization
Organization Name:STANDING ROCK PUBLIC TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TERNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-854-8010
Mailing Address - Street 1:1341 92ND STREET
Mailing Address - Street 2:
Mailing Address - City:FORT YATES
Mailing Address - State:ND
Mailing Address - Zip Code:58538
Mailing Address - Country:US
Mailing Address - Phone:701-854-8090
Mailing Address - Fax:701-854-3061
Practice Address - Street 1:1341 92ND STREET
Practice Address - Street 2:
Practice Address - City:FORT YATES
Practice Address - State:ND
Practice Address - Zip Code:58538
Practice Address - Country:US
Practice Address - Phone:701-854-8090
Practice Address - Fax:701-854-3061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDSBC 202343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)