Healthcare Provider Details

I. General information

NPI: 1104042266
Provider Name (Legal Business Name): ABERDEEN AREA TRIBAL CHAIRMANS HEALTH BOARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 03/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 BELLISLE
ST MICHAEL ND
58370
US

IV. Provider business mailing address

1770 RAND RD
RAPID CITY SD
57702
US

V. Phone/Fax

Practice location:
  • Phone: 701-766-1244
  • Fax: 701-766-1245
Mailing address:
  • Phone: 605-721-1922
  • Fax: 605-721-1932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateND

VIII. Authorized Official

Name: MS. SUNNY COLMBE
Title or Position: CFO
Credential: MBA
Phone: 605-721-1922