Healthcare Provider Details

I. General information

NPI: 1295758266
Provider Name (Legal Business Name): ST BENEDICT HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W GLYNN DR
PARKSTON SD
57366-9605
US

IV. Provider business mailing address

401 W GLYNN DR
PARKSTON SD
57366-9605
US

V. Phone/Fax

Practice location:
  • Phone: 605-928-7961
  • Fax: 605-928-4417
Mailing address:
  • Phone: 605-928-7961
  • Fax: 605-928-4417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY R WEBER
Title or Position: CEO
Credential:
Phone: 605-928-3311