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602 1st St Ne Suite 1 Wessington Springs SD 57382-2167 | |
(605) 539-1778 | |
(605) 539-9546 |
Full Name | |
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Speciality | Clinic/Center |
Location | 602 1st St Ne, Wessington Springs, South Dakota |
Authorized Official Name and Position | John 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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602 1st St Ne Suite 1 Wessington Springs SD 57382-2167 Ph: (605) 539-1778 | 602 1st St Ne Suite 1 Wessington Springs SD 57382-2167 Ph: (605) 539-1778 |
NPI Number | 1831207844 |
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Provider Enumeration Date | 08/29/2006 |
Last Update Date | 10/11/2007 |
Medicare PECOS PAC ID | 8921997933 |
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Medicare Enrollment ID | O20080826000621 |
Identifier | Type | State | Issuer |
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1831207844 | NPI | - | NPPES |
5350102 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |