Healthcare Provider Details

I. General information

NPI: 1750400537
Provider Name (Legal Business Name): BUNKERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 S BROADBAND LN STE 100
SIOUX FALLS SD
57108-2329
US

IV. Provider business mailing address

5010 S BROADBAND LN STE 100
SIOUX FALLS SD
57108-2329
US

V. Phone/Fax

Practice location:
  • Phone: 605-271-1348
  • Fax: 605-610-1477
Mailing address:
  • Phone: 605-359-0441
  • Fax: 605-610-1477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1755
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier6570773
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer
# 2
Identifier0040052
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerBLUE CROSS BLUE SHIELD

VIII. Authorized Official

Name: JEANNE M BUNKERS
Title or Position: OWNER-PSYCHOTHERAPIST
Credential: MSW, LCSW-PIP
Phone: 605-271-1348