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General NPI Number Information
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NPI Number | 1356311716
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Entity Type | Organization
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Legal Business Name | FIVE COUNTIES HOSPITAL & NURSING HOME
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 405 6TH AVE. W.
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City | LEMMON
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State | SD
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Zip | 57638-0479
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Country | US
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Telephone | 605-374-3871
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Fax | 605-374-3169
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Provider Business Mailing Address
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Address Line | 405 6TH AVE. W. PO BOX 479
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City | LEMMON
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State | SD
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Zip | 57638-0479
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Country | US
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Telephone | 605-374-3871
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Fax | 605-374-3169
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Authorized Official
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Title or Position | BILLING/ACCOUNTS RECEIVABLE
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Name | MS. JENNIFER G ANDERSON
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Credential |
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Telephone | 605-374-3871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 10641
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License Number State | SD
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