Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 741 S Hill St, Salem, 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 | 741 S Hill St Salem SD 57058-8761 Ph: (605) 425-3038 |
NPI Number | 1639174568 |
---|---|
Provider Enumeration Date | 06/16/2005 |
Last Update Date | 08/20/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639174568 | NPI | - | NPPES |
5307010 | Medicaid | SD | |
5307012 | Medicaid | SD | |
4998666 | Other | SD | WELLMARK |
00-00592 | Other | SD | MEDICA |
CR0890 | Other | SD | MEDICARE RR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | N/A (South Dakota) | Primary |