White Lake Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

102 Issued in SD

Legal business name

WHITE LAKE AMBULANCE SERVICE

Practice address

209 North Main Street
White Lake, SD 57383-0245

Phone

(605) 249-2279

NPI assigned

Apr 23, 2007

Last updated

Apr 16, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carol Schroeder

Title

Secretary

Phone

(605) 249-2279

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1417175373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 245",
            "city": "WHITE LAKE",
            "state": "SD",
            "postal_code": "573830245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 NORTH MAIN STREET",
            "city": "WHITE LAKE",
            "state": "SD",
            "postal_code": "573830245",
            "telephone_number": "605-249-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE LAKE AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "605-249-2279"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SD",
            "license": "102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000642",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aurora Brule Nursing Home, Inc.
• Platte Community Memorial Hospital, Inc (White Lake Medical Clinic Avera)
• Platte Community Memorial Hospital, Inc. (White Lake Medical Clinic Avera)

• Land Ambulance in White Lake, SD
• Providers in White Lake, SD by specialty
• Land Ambulance in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.