Healthcare Provider Details

I. General information

NPI: 1588819783
Provider Name (Legal Business Name): BROOKINGS FAMILY PLANNING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2008
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 N CAMPUS DR WELLNESS CENTER
BROOKINGS SD
57107-0001
US

IV. Provider business mailing address

1440 N CAMPUS DR WELLNESS CENTER BOX 2818
BROOKINGS SD
57107-0001
US

V. Phone/Fax

Practice location:
  • Phone: 605-688-4157
  • Fax: 605-688-6450
Mailing address:
  • Phone: 605-688-4157
  • Fax: 605-688-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: TAMARA LYNNE LUNDAY
Title or Position: DIRECTOR SHCCS-SDSU
Credential:
Phone: 605-688-4157