| Family Health Center Of Eagle Butte | |
|
8000 E Hwy 212 Eagle Butte SD 57625-0860 | |
| (605) 964-8000 | |
| (605) 964-1118 |
| Full Name | Family Health Center Of Eagle Butte |
|---|---|
| Speciality | Clinic/Center |
| Location | 8000 E Hwy 212, Eagle Butte, South Dakota |
| Authorized Official Name and Position | John Mengenhausen (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6057724525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Center Of Eagle Butte Po Box 860 8000 E Hwy 212 Eagle Butte SD 57625-0860 Ph: (605) 964-8000 | Family Health Center Of Eagle Butte 8000 E Hwy 212 Eagle Butte SD 57625-0860 Ph: (605) 964-8000 |
| NPI Number | 1558335349 |
|---|---|
| Provider Enumeration Date | 02/16/2006 |
| Last Update Date | 02/06/2017 |
| Medicare PECOS PAC ID | 8921997933 |
|---|---|
| Medicare Enrollment ID | O20160209002288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558335349 | NPI | - | NPPES |
| 5350050 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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