Healthcare Provider Details
I. General information
NPI: 1972575173
Provider Name (Legal Business Name): CITY OF REDFIELD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2006
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1010 W 1ST ST
REDFIELD SD
57469-1506
US
IV. Provider business mailing address
PO BOX 590
REDFIELD SD
57469-0590
US
V. Phone/Fax
- Phone: 605-472-0510
- Fax: 605-472-0331
- Phone: 605-472-0510
- Fax: 605-472-0331
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
E
SJURSETH
Title or Position: CEO ADMINISTRATOR
Credential:
Phone: 605-472-1110