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General NPI Number Information
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NPI Number | 1538582416
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Entity Type | Organization
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Legal Business Name | PRAIRIE COMMUNITY HEALTH INC
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Dates
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Enumeration Date | 01/28/2014
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | 223 A ST
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City | DUPREE
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State | SD
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Zip | 57623-9998
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Country | US
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Telephone | 605-466-2122
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Fax | 605-466-2504
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Provider Business Mailing Address
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Address Line | PO BOX 195
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City | MC INTOSH
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State | SD
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Zip | 57641-0195
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Country | US
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Telephone | 605-273-4335
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Fax | 605-273-4360
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Authorized Official
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Title or Position | CEO
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Name | PAMELA LOCKEN
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Credential |
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Telephone | 605-466-2122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | SD
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