Healthcare Provider Details

I. General information

NPI: 1003887571
Provider Name (Legal Business Name): ROSCOE FAMILY CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 W MERRILL AVE
ROSCOE SD
57471-0260
US

IV. Provider business mailing address

206 W MERRILL AVE PO BOX 260
ROSCOE SD
57471-0260
US

V. Phone/Fax

Practice location:
  • Phone: 605-287-4900
  • Fax: 605-287-4901
Mailing address:
  • Phone: 605-287-4900
  • Fax: 605-287-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ESTHER M PRESZLER
Title or Position: OWNER
Credential: CNP
Phone: 605-287-4900