Healthcare Provider Details

I. General information

NPI: 1427470095
Provider Name (Legal Business Name): LACREEK ELECTRIC ASSN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 12/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N HAROLD ST
MARTIN SD
57551-8903
US

IV. Provider business mailing address

PO BOX 220
MARTIN SD
57551-0220
US

V. Phone/Fax

Practice location:
  • Phone: 605-685-6581
  • Fax: 605-685-6957
Mailing address:
  • Phone: 605-685-6581
  • Fax: 605-685-6957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: WAYNE A STERKEL
Title or Position: GENERAL MANAGER
Credential:
Phone: 605-685-6581