Fort Thompson Community Health Center | |
125 Sd Hwy 249 Fort Thompson SD 57339 | |
(605) 539-9836 | |
Not Available |
Full Name | Fort Thompson Community Health Center |
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Speciality | Clinic/Center |
Location | 125 Sd Hwy 249, Fort Thompson, South Dakota |
Authorized Official Name and Position | John Ray Mengenhausen (CEO) |
Authorized Official Contact | 6057724525 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fort Thompson Community Health Center 125 Sd Hwy 249 Fort Thompson SD 57339 Ph: () - | Fort Thompson Community Health Center 125 Sd Hwy 249 Fort Thompson SD 57339 Ph: (605) 539-9836 |
NPI Number | 1225411945 |
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Provider Enumeration Date | 06/30/2015 |
Last Update Date | 03/29/2016 |
Medicare PECOS PAC ID | 8921997933 |
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Medicare Enrollment ID | O20150724010054 |
Identifier | Type | State | Issuer |
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1225411945 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Fort Thompson Indian Health Service Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Hwy 34 & 47, Fort Thompson, SD 57339 Phone: 605-245-1500 Fax: 605-245-2384 |