Fall River Clinic | |
1201 Highway 71 South Hot Springs SD 57747-1374 | |
(605) 745-3159 | |
(605) 745-3957 |
Full Name | Fall River Clinic |
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Speciality | Clinic/Center |
Location | 1201 Highway 71 South, Hot Springs, South Dakota |
Authorized Official Name and Position | John B Miller (ADMINISTRATOR) |
Authorized Official Contact | 6057453159 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fall River Clinic 1201 Highway 71 South Hot Springs SD 57747-1374 Ph: (605) 745-3159 | Fall River Clinic 1201 Highway 71 South Hot Springs SD 57747-1374 Ph: (605) 745-3159 |
NPI Number | 1043228810 |
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Provider Enumeration Date | 08/04/2006 |
Last Update Date | 07/30/2010 |
Medicare PECOS PAC ID | 3678485075 |
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Medicare Enrollment ID | O20040212000533 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043228810 | NPI | - | NPPES |
5340260 | Medicaid | SD | |
83423 | Other | SD | WELLMARK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Wesley L Sufficool |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1043309891 PECOS PAC ID: 5294620530 Enrollment ID: I20050714000424 |
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