Isabel Community Clinic | |
118 N Main Street Isabel SD 57633-0097 | |
(605) 466-2120 | |
(605) 466-2190 |
Full Name | Isabel Community Clinic |
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Speciality | Clinic/Center |
Location | 118 N Main Street, Isabel, South Dakota |
Authorized Official Name and Position | John Mengenhausen (AUTHORIZED OFFICIAL 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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Isabel Community Clinic Po Box 97 Isabel SD 57633-0097 Ph: (605) 466-2120 | Isabel Community Clinic 118 N Main Street Isabel SD 57633-0097 Ph: (605) 466-2120 |
NPI Number | 1205800075 |
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Provider Enumeration Date | 02/16/2006 |
Last Update Date | 02/06/2017 |
Medicare PECOS PAC ID | 8921997933 |
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Medicare Enrollment ID | O20160209002136 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205800075 | NPI | - | NPPES |
77913 | Other | MED B GROUP | |
5350090 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |