Provider Demographics
NPI:1295916856
Name:CITY OF ELKTON
Entity type:Organization
Organization Name:CITY OF ELKTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:STUEFEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-542-5621
Mailing Address - Street 1:109 ELK STREET S
Mailing Address - Street 2:PO BOX 308
Mailing Address - City:ELKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57026
Mailing Address - Country:US
Mailing Address - Phone:605-542-5621
Mailing Address - Fax:605-542-8141
Practice Address - Street 1:109 ELK STREET S
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:SD
Practice Address - Zip Code:57026
Practice Address - Country:US
Practice Address - Phone:605-542-5621
Practice Address - Fax:605-542-8141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0623416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD=========OtherEIN
SD=========OtherEIN