| Document Date: 2013-02-22 16:10:06
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City APPLICATION / GOVERNORS DRIVE PIERRE / / IndustryTerm electronic media / medical transportation services / transportation reimbursement / medical transportation assistance / law implementing / transportation expenses / / Organization Department of Health / Medicaid Fraud Control Unit / ARSD Chapter / office of Finance/EBT / / Person Sandra Vanneman / / / Position Program Administrator / / Product CERTIFICATION REGARDING SUSPENSION / / ProvinceOrState South Dakota / A. B. / South / /
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PROVIDER AGREEMENT To Participate in the Title XIX Non-Emergency Medical Transportation Program The following agreement to participate in the South Dakota Title XIX Non-Emergency Medical Transportation program is entered