| Wall Regional Medical Clinic | |
|
112 7th Avenue Wall SD 57790-0001 | |
| (605) 279-2149 | |
| (605) 279-1027 |
| Full Name | Wall Regional Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 112 7th Avenue, Wall, South Dakota |
| Authorized Official Name and Position | John Pierce (MONUMENT HEALTH PRESIDENT) |
| Authorized Official Contact | 6057558162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wall Regional Medical Clinic Po Box 860013 Minneapolis MN 55486-0013 Ph: (605) 279-2149 | Wall Regional Medical Clinic 112 7th Avenue Wall SD 57790-0001 Ph: (605) 279-2149 |
| NPI Number | 1457730673 |
|---|---|
| Provider Enumeration Date | 05/20/2015 |
| Last Update Date | 03/16/2020 |
| Medicare PECOS PAC ID | 6002729506 |
|---|---|
| Medicare Enrollment ID | O20160308000849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457730673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Wall Regional Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 7th Avenue, Wall, SD 57790 Phone: 605-279-2149 Fax: 605-279-2139 | |
Wall Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 7th Ave, Wall, SD 57790 Phone: 605-279-2149 Fax: 605-279-2139 | |
Wall Regional Medical Clinic Part B Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 7th Avenue, Wall, SD 57790 Phone: 605-279-2149 Fax: 605-279-1027 | |
Wall Regional Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 7th Avenue, Wall, SD 57790 Phone: 605-279-2149 Fax: 605-279-2139 | |
Wall Regional Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 7th Avenue, Wall, SD 57790 Phone: 605-279-2149 Fax: 605-279-2139 |