| |
506 S Wilson St Aberdeen SD 57401-5082 | |
(605) 725-3900 | |
(605) 725-3901 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 506 S Wilson St, Aberdeen, South Dakota |
Authorized Official Name and Position | John Mengenhausen (CEO) |
Authorized Official Contact | 6057724525 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
506 S Wilson St Aberdeen SD 57401-5082 Ph: (605) 725-3900 | 506 S Wilson St Aberdeen SD 57401-5082 Ph: (605) 725-3900 |
NPI Number | 1104248475 |
---|---|
Provider Enumeration Date | 01/06/2014 |
Last Update Date | 08/17/2020 |
Medicare PECOS PAC ID | 8921997933 |
---|---|
Medicare Enrollment ID | O20140327002014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104248475 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Kathleen Van De Walle Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1314 N Main St, Aberdeen, SD 57401 Phone: 605-229-3682 | |
Tiny Knight Safety And Assurance Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 S Main St Ste 530, Aberdeen, SD 57401 Phone: 605-216-9777 | |
Internal Medicine Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 S Lloyd St, Suite E101, Aberdeen, SD 57401 Phone: 605-225-8800 Fax: 605-225-1302 |