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104 W 2nd St Alcester SD 57001-2281 | |
(605) 934-2122 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 104 W 2nd St, Alcester, 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 |
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602 1st St Ne Ste 1 Wessington Springs SD 57382-2163 Ph: (605) 539-9836 | 104 W 2nd St Alcester SD 57001-2281 Ph: (605) 934-2122 |
NPI Number | 1598293482 |
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Provider Enumeration Date | 05/23/2017 |
Last Update Date | 05/23/2017 |
Medicare PECOS PAC ID | 8921997933 |
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Medicare Enrollment ID | O20171030002174 |
Identifier | Type | State | Issuer |
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1598293482 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |