| West Dakota Health Center | |
|
906 Main St Timber Lake SD 57656 | |
| (605) 865-3258 | |
| Not Available |
| Full Name | West Dakota Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 906 Main St, Timber Lake, South Dakota |
| Authorized Official Name and Position | Renae Tisdall (CFO) |
| Authorized Official Contact | 6058458164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Dakota Health Center Po Box 206 Timber Lake SD 57656-0206 Ph: (605) 865-3258 | West Dakota Health Center 906 Main St Timber Lake SD 57656 Ph: (605) 865-3258 |
| NPI Number | 1841267341 |
|---|---|
| Provider Enumeration Date | 03/02/2006 |
| Last Update Date | 10/06/2016 |
| Medicare PECOS PAC ID | 6507776135 |
|---|---|
| Medicare Enrollment ID | O20090209000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841267341 | NPI | - | NPPES |
| 5341010 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Missouri Breaks Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Hc 64 Box 52, Timber Lake, SD 57656 Phone: 605-964-3418 Fax: 605-934-3415 |