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General NPI Number Information
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NPI Number | 1447803432
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Entity Type | Organization
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Legal Business Name | CITY OF BROOKINGS
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 104 1/2 WEST 2ND STREET
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City | ELKTON
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State | SD
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Zip | 57026
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Country | US
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Telephone | 605-696-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 300 22ND AVE
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City | BROOKINGS
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State | SD
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Zip | 57006-2480
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MELISSA WAGNER
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Credential |
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Telephone | 605-696-8014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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