Maverick Health Care, Prof. Llc | |
2200 13th Ave Belle Fourche SD 57717-2215 | |
(605) 892-3331 | |
Not Available |
Full Name | Maverick Health Care, Prof. Llc |
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Speciality | Clinic/Center |
Location | 2200 13th Ave, Belle Fourche, South Dakota |
Authorized Official Name and Position | Helen Anne Kuehlman (MEDICAL DIRECTOR / OWNER OF LLC) |
Authorized Official Contact | 8155314028 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Maverick Health Care, Prof. Llc 2625 Maverick Ct Spearfish SD 57783-9702 Ph: (815) 531-4028 | Maverick Health Care, Prof. Llc 2200 13th Ave Belle Fourche SD 57717-2215 Ph: (605) 892-3331 |
NPI Number | 1104559814 |
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Provider Enumeration Date | 07/08/2022 |
Last Update Date | 07/18/2022 |
Medicare PECOS PAC ID | 8527442540 |
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Medicare Enrollment ID | O20220825000215 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104559814 | NPI | - | NPPES |
1104559814 | Other | FAMILY MEDICINE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Helen Anne Kuehlman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932380003 PECOS PAC ID: 3375623945 Enrollment ID: I20140214001649 |
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