| Avera St. Benedict Certified Rural Health Clinic, Lake Andes | |
|
756 East Lake Street Lake Andes SD 57356 | |
| (605) 487-7878 | |
| (605) 487-9566 |
| Full Name | Avera St. Benedict Certified Rural Health Clinic, Lake Andes |
|---|---|
| Speciality | Clinic/Center |
| Location | 756 East Lake Street, Lake Andes, South Dakota |
| Authorized Official Name and Position | Lindsay R Weber (CEO) |
| Authorized Official Contact | 6059283311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera St. Benedict Certified Rural Health Clinic, Lake Andes Po Box 279 Lake Andes SD 57356-0279 Ph: (605) 487-7878 | Avera St. Benedict Certified Rural Health Clinic, Lake Andes 756 East Lake Street Lake Andes SD 57356 Ph: (605) 487-7878 |
| NPI Number | 1114931797 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 11/30/2022 |
| Medicare PECOS PAC ID | 4880507672 |
|---|---|
| Medicare Enrollment ID | O20100609000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114931797 | NPI | - | NPPES |
| 5340060 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Avera St Benedict Rhc Lake Andes Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 756 E Lake St, Lake Andes, SD 57356 Phone: 605-487-7878 Fax: 605-487-9566 |