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Ambulatory Health Care Facilities Clinic/Center Emergency Care

Provider NPI: 1962657338

Organization Information:
Organization is not Subpart
Authorized Official:  WILLIAM  POURIER  CEO  605-867-5131

Practice Location:
Tel: 605-867-5131  Fax: 605-867-3263

Business Mailing Address:
Tel: 605-867-5131  Fax: 605-867-3262

NPI Information:
NPI: 1962657338
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y261QE0002XAmbulatory Health Care Facilities
Emergency Care

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 261QE0002X





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