Provider Demographics
NPI:1548366925
Name:AVON SAVE A LIFE AMBULANCE
Entity type:Organization
Organization Name:AVON SAVE A LIFE AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY FINANCE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERNDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-286-3694
Mailing Address - Street 1:BOX 207
Mailing Address - Street 2:116 N MAIN ST
Mailing Address - City:AVON
Mailing Address - State:SD
Mailing Address - Zip Code:57315-0207
Mailing Address - Country:US
Mailing Address - Phone:605-286-3694
Mailing Address - Fax:605-286-3694
Practice Address - Street 1:105 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:SD
Practice Address - Zip Code:57315-0207
Practice Address - Country:US
Practice Address - Phone:605-286-3694
Practice Address - Fax:605-286-3694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport