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101 S Front St Ste 1 Chamberlain SD 57325-1619 | |
(605) 234-6584 | |
(605) 234-5002 |
Full Name | |
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Speciality | Clinic/Center |
Location | 101 S Front St Ste 1, Chamberlain, South Dakota |
Authorized Official Name and Position | James Hardwick (CEO) |
Authorized Official Contact | 6052232200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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101 S Front St Ste 1 Chamberlain SD 57325-1619 Ph: (605) 234-6584 | 101 S Front St Ste 1 Chamberlain SD 57325-1619 Ph: (605) 234-6584 |
NPI Number | 1750705232 |
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Provider Enumeration Date | 02/05/2014 |
Last Update Date | 11/12/2021 |
Medicare PECOS PAC ID | 3476447541 |
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Medicare Enrollment ID | O20141117000540 |
Identifier | Type | State | Issuer |
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1750705232 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |