Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 208 Main Street, Herreid, South Dakota |
Authorized Official Name and Position | Lukas Fischer (CEO) |
Authorized Official Contact | 7012544511 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
208 Main Street Herreid SD 57632 Ph: (605) 437-2678 | 208 Main Street Herreid SD 57632 Ph: (605) 437-2678 |
NPI Number | 1629175237 |
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Provider Enumeration Date | 09/19/2006 |
Last Update Date | 08/02/2022 |
Medicare PECOS PAC ID | 5294646345 |
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Medicare Enrollment ID | O20050317000350 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629175237 | NPI | - | NPPES |
5300092 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |