Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 104 W Birch, Arlington, South Dakota |
Authorized Official Name and Position | Melissa Wagner (CFO) |
Authorized Official Contact | 6056969000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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300 22nd Ave Brookings SD 57006-2480 Ph: (605) 696-9000 | 104 W Birch Arlington SD 57212 Ph: (605) 983-3283 |
NPI Number | 1902123581 |
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Provider Enumeration Date | 04/22/2010 |
Last Update Date | 12/04/2018 |
Medicare PECOS PAC ID | 1052307105 |
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Medicare Enrollment ID | O20100817001515 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902123581 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |