Provider Demographics
NPI:1912981259
Name:PIEDMONT VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:PIEDMONT VOLUNTEER FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:LINNEWEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-787-5121
Mailing Address - Street 1:PO BOX 334
Mailing Address - Street 2:11039 PARK ST
Mailing Address - City:PIEDMONT
Mailing Address - State:SD
Mailing Address - Zip Code:57769-0334
Mailing Address - Country:US
Mailing Address - Phone:605-787-5121
Mailing Address - Fax:605-787-6958
Practice Address - Street 1:11039 PARK ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SD
Practice Address - Zip Code:57769-0334
Practice Address - Country:US
Practice Address - Phone:605-787-5121
Practice Address - Fax:605-787-6958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4933416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9010930Medicaid
SD9010930Medicaid