Healthcare Provider Details

I. General information

NPI: 1881340503
Provider Name (Legal Business Name): CITY OF STURGIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 BALLPARK RD
STURGIS SD
57785-3128
US

IV. Provider business mailing address

1901 BALLPARK RD
STURGIS SD
57785-3128
US

V. Phone/Fax

Practice location:
  • Phone: 605-347-5801
  • Fax: 605-347-2558
Mailing address:
  • Phone: 605-347-5801
  • Fax: 605-347-2558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: HALLI SCHULZ
Title or Position: FRONT OFFICE SUPERVISOR
Credential:
Phone: 605-347-5801