Healthcare Provider Details

I. General information

NPI: 1588674584
Provider Name (Legal Business Name): CITY OF REDFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 W 2ND ST
REDFIELD SD
57469-1501
US

IV. Provider business mailing address

111 W 10TH AVE
REDFIELD SD
57469-1519
US

V. Phone/Fax

Practice location:
  • Phone: 605-472-1110
  • Fax:
Mailing address:
  • Phone: 605-472-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1162450001
License Number StateSD

VIII. Authorized Official

Name: KAREN E. SJURSETH
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 605-472-1110