| Brookings Health System White Clinic | |
|
302 E 5th Street White SD 57276-2061 | |
| (605) 696-9000 | |
| (605) 696-7751 |
| Full Name | Brookings Health System White Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 302 E 5th Street, White, South Dakota |
| Authorized Official Name and Position | Melissa Wagner (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6056969000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookings Health System White Clinic 300 22nd Ave Brookings SD 57006-2480 Ph: (605) 696-9000 | Brookings Health System White Clinic 302 E 5th Street White SD 57276-2061 Ph: (605) 696-9000 |
| NPI Number | 1912279829 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 12/04/2018 |
| Medicare PECOS PAC ID | 1052307105 |
|---|---|
| Medicare Enrollment ID | O20120507000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912279829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
White Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 East Fifth Street, White, SD 57276 Phone: 605-629-8211 Fax: 605-629-8291 |