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General NPI Number Information
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NPI Number | 1801989967
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Entity Type | Organization
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Legal Business Name | SACRED HEART RURAL HEALTH CLINICS
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 25410 PARK AVE APARTMENT E
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City | NIOBRARA
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State | NE
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Zip | 68760-7044
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Country | US
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Telephone | 402-857-3398
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Fax | 402-857-3315
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Provider Business Mailing Address
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Address Line | 1000 W 4TH ST SUITE 8
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City | YANKTON
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State | SD
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Zip | 57078-3730
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Country | US
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Telephone | 605-655-1201
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Fax | 605-655-1210
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. PAM REZAC
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Credential |
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Telephone | 605-668-8322
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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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