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General NPI Number Information
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NPI Number | 1972751766
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Entity Type | Organization
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Legal Business Name | ARLINGTON MEDICAL CLINIC
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 104 W. BIRCH
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City | ARLINGTON
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State | SD
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Zip | 57212
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Country | US
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Telephone | 605-983-3293
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Fax | 605-983-5112
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Provider Business Mailing Address
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Address Line | 104 W. BIRCH ST PO BOX 291
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City | ARLINGTON
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State | SD
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Zip | 57212
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Country | US
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Telephone | 605-983-3293
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Fax | 605-983-5112
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Authorized Official
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Title or Position | OWNER
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Name | MR. AMIEL N REDFISH
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Credential | PA
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Telephone | 605-983-3283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 0173
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License Number State | SD
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