| Avera St. Benedict Crhc, Tripp | |
|
310 S Main St Tripp SD 57376-2109 | |
| (605) 935-7211 | |
| Not Available |
| Full Name | Avera St. Benedict Crhc, Tripp |
|---|---|
| Speciality | Clinic/Center |
| Location | 310 S Main St, Tripp, South Dakota |
| Authorized Official Name and Position | Lindsay Rae Weber (CEO) |
| Authorized Official Contact | 6059357211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera St. Benedict Crhc, Tripp 401 W Glynn Dr Parkston SD 57366-9605 Ph: (605) 928-3311 | Avera St. Benedict Crhc, Tripp 310 S Main St Tripp SD 57376-2109 Ph: (605) 935-7211 |
| NPI Number | 1740355635 |
|---|---|
| Provider Enumeration Date | 11/24/2006 |
| Last Update Date | 11/02/2022 |
| Medicare PECOS PAC ID | 4880507672 |
|---|---|
| Medicare Enrollment ID | O20100615000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740355635 | NPI | - | NPPES |
| 5340070 | Medicaid | SD | |
| 4997658 | Other | SD | WELLMARK TRIPP CLINIC |
| 5340340 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (South Dakota) | Primary |
Avera St Benedict Crhc Tripp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 S Main St, Tripp, SD 57376 Phone: 605-935-7211 Fax: 605-935-7212 |