Provider Demographics
NPI:1720175060
Name:LAKOTA AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:LAKOTA AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SCHUH
Authorized Official - Suffix:
Authorized Official - Credentials:EMT I
Authorized Official - Phone:701-247-2312
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:LAKOTA
Mailing Address - State:ND
Mailing Address - Zip Code:58344-0338
Mailing Address - Country:US
Mailing Address - Phone:701-247-2312
Mailing Address - Fax:
Practice Address - Street 1:107 2ND ST E
Practice Address - Street 2:
Practice Address - City:LAKOTA
Practice Address - State:ND
Practice Address - Zip Code:58344-0338
Practice Address - Country:US
Practice Address - Phone:701-247-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND065146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty