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General NPI Number Information
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NPI Number | 1194843284
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Entity Type | Organization
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Legal Business Name | SEMCAC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 76 W 3RD ST
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City | WINONA
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State | MN
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Zip | 55987-3431
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Country | US
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Telephone | 507-452-4307
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Fax | 507-457-0564
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Provider Business Mailing Address
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Address Line | PO BOX 549 204 S. ELM ST
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City | RUSHFORD
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State | MN
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Zip | 55971-0549
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Country | US
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Telephone | 507-864-7741
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Fax | 507-864-2440
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Authorized Official
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Title or Position | HEALTH SERVICES DIRECTOR
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Name | JOYCE PECKOVER
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Credential | R.N., M.S.N.
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Telephone | 507-452-4307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State | MN
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