Healthcare Provider Details

I. General information

NPI: 1740355635
Provider Name (Legal Business Name): ST. BENEDICT HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 11/02/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S MAIN ST
TRIPP SD
57376-2109
US

IV. Provider business mailing address

401 W GLYNN DR
PARKSTON SD
57366-9605
US

V. Phone/Fax

Practice location:
  • Phone: 605-935-7211
  • Fax:
Mailing address:
  • Phone: 605-928-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateSD

VIII. Authorized Official

Name: LINDSAY RAE WEBER
Title or Position: CEO
Credential:
Phone: 605-935-7211