| Mellette County Health Center | |
|
309 E 4th St White River SD 57579-0281 | |
| (605) 259-3121 | |
| Not Available |
| Full Name | Mellette County Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 309 E 4th St, White River, 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 |
|---|---|
| Mellette County Health Center Po Box 281 White River SD 57579-0281 Ph: (605) 259-3121 | Mellette County Health Center 309 E 4th St White River SD 57579-0281 Ph: (605) 259-3121 |
| NPI Number | 1962511014 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 02/09/2017 |
| Medicare PECOS PAC ID | 8921997933 |
|---|---|
| Medicare Enrollment ID | O20080922000513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962511014 | NPI | - | NPPES |
| 5350230 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Horizon Health Care, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: First And Roosevelt, White River, SD 57579 Phone: 605-259-3121 Fax: 605-259-3444 |