Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 265 Main Street, Corsica, South Dakota |
Authorized Official Name and Position | Douglas Ekeren (PRESIDENT/CEO) |
Authorized Official Contact | 6056688322 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
525 N Foster St Mitchell SD 57301-2966 Ph: (605) 995-2000 | 265 Main Street Corsica SD 57328 Ph: (605) 946-5411 |
NPI Number | 1952635492 |
---|---|
Provider Enumeration Date | 10/01/2009 |
Last Update Date | 08/20/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952635492 | NPI | - | NPPES |
4991000 | Other | SD | WELLMARK |
5306743 | Medicaid | SD | |
00-00435 | Other | SD | MEDICA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | NA (South Dakota) | Primary |