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205 Orchard Drive Sisseton SD 57262-2398 | |
(605) 698-7681 | |
(605) 698-3493 |
Full Name | |
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Speciality | Clinic/Center |
Location | 205 Orchard Drive, Sisseton, South Dakota |
Authorized Official Name and Position | Craig Kantos (CEO) |
Authorized Official Contact | 6056984601 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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205 Orchard Drive Sisseton SD 57262-2398 Ph: (605) 698-7681 | 205 Orchard Drive Sisseton SD 57262-2398 Ph: (605) 698-7681 |
NPI Number | 1881740629 |
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Provider Enumeration Date | 01/26/2007 |
Last Update Date | 08/08/2024 |
Medicare PECOS PAC ID | 8022926468 |
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Medicare Enrollment ID | O20021113000030 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881740629 | NPI | - | NPPES |
12440 | Medicaid | ND | |
5340220 | Medicaid | SD | |
C07780 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 60020 (South Dakota) | Primary |
Us Dept Of Health & Human Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Lake Traverse Dr, Sisseton, SD 57262 Phone: 605-698-7606 | |
Sisseton Wahpeton Health Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Lake Traverse Dr, Sisseton, SD 57262 Phone: 605-698-7606 | |