1114355765 NPI number — GROTON COMMUNITY TRANSIT, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114355765 NPI number — GROTON COMMUNITY TRANSIT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GROTON COMMUNITY TRANSIT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114355765
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 693
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GROTON
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-397-8661
Provider Business Mailing Address Fax Number:
605-397-8661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 E 2ND AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GROTON
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-397-8661
Provider Business Practice Location Address Fax Number:
605-397-8661
Provider Enumeration Date:
10/17/2013

Additional Information

Authorized Official

Authorized Official Last Name:
DOEDEN
Authorized Official First Name:
ARLIS
Authorized Official Middle Name:
F
Authorized Official Title or Position:
TRANSIT DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
605-397-8661

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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