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General NPI Number Information
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NPI Number | 1962584037
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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 | 10/19/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1000 W 4TH ST STE 2
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City | YANKTON
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State | SD
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Zip | 57078-3700
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Country | US
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Telephone | 605-668-8601
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Fax | 605-668-8605
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Provider Business Mailing Address
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Address Line | 1000 W 4TH ST STE 2
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City | YANKTON
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State | SD
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Zip | 57078-3700
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Country | US
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Telephone | 605-668-8601
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Fax | 605-668-8605
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | PAMELA 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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 172
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License Number State | SD
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