Healthcare Provider Details

I. General information

NPI: 1801989967
Provider Name (Legal Business Name): SACRED HEART RURAL HEALTH CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25410 PARK AVE APARTMENT E
NIOBRARA NE
68760-7044
US

IV. Provider business mailing address

1000 W 4TH ST SUITE 8
YANKTON SD
57078-3730
US

V. Phone/Fax

Practice location:
  • Phone: 402-857-3398
  • Fax: 402-857-3315
Mailing address:
  • Phone: 605-655-1201
  • Fax: 605-655-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAM REZAC
Title or Position: PRESIDENT/CEO
Credential:
Phone: 605-668-8322