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General NPI Number Information
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NPI Number | 1609013317
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Entity Type | Organization
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Legal Business Name | DOUGLAS COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 310 W SD HIGHWAY 46
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City | WAGNER
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State | SD
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Zip | 57380-9304
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Country | US
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Telephone | 605-724-2151
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Fax |
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Provider Business Mailing Address
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Address Line | 310 W SD HIGHWAY 46
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City | WAGNER
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State | SD
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Zip | 57380-9304
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Country | US
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Telephone | 605-384-4577
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Fax |
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Authorized Official
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Title or Position | CPC, CPC-H
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Name | NICOLE J NEUGEBAUER
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Credential |
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Telephone | 605-724-2151
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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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