Destiny Healthcare International, Inc | |
1417 S Minnesota Ave Sioux Falls SD 57105-1715 | |
(605) 339-3378 | |
(605) 339-0710 |
Full Name | Destiny Healthcare International, Inc |
---|---|
Speciality | Family Medicine |
Location | 1417 S Minnesota Ave, Sioux Falls, South Dakota |
Authorized Official Name and Position | Brian K Kidman (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6053393378 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Destiny Healthcare International, Inc 1417 S Minnesota Ave Sioux Falls SD 57105-1715 Ph: (605) 339-3378 | Destiny Healthcare International, Inc 1417 S Minnesota Ave Sioux Falls SD 57105-1715 Ph: (605) 339-3378 |
NPI Number | 1356369995 |
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Provider Enumeration Date | 07/18/2006 |
Last Update Date | 03/17/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356369995 | NPI | - | NPPES |
6701870 | Medicaid | SD | |
5604647 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 1799 (South Dakota) | Primary |
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