| Bon Homme Family Practice - Avon | |
|
410 W 16th Ave Tyndall SD 57066-2318 | |
| (605) 589-2100 | |
| (605) 589-2115 |
| Full Name | Bon Homme Family Practice - Avon |
|---|---|
| Speciality | Clinic/Center |
| Location | 410 W 16th Ave, Tyndall, South Dakota |
| Authorized Official Name and Position | Ashli Danilko (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6055892152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bon Homme Family Practice - Avon 410 W 16th Ave Tyndall SD 57066-2318 Ph: (605) 589-2100 | Bon Homme Family Practice - Avon 410 W 16th Ave Tyndall SD 57066-2318 Ph: (605) 589-2100 |
| NPI Number | 1558305243 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 09/21/2020 |
| Medicare PECOS PAC ID | 2668380262 |
|---|---|
| Medicare Enrollment ID | O20100729000938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558305243 | NPI | - | NPPES |
| 5340152 | Medicaid | SD | |
| 4996776 | Other | SD | RHC BCBS AVON |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Bon Homme Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 W 16th Ave, Tyndall, SD 57066 Phone: 605-589-2100 Fax: 605-589-2115 | |
St. Michael's Hospital, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 W 16th Ave, Tyndall, SD 57066 Phone: 605-589-2100 Fax: 605-589-2115 |