| Maverick Health Care, Prof. Llc | |
|
2200 13th Ave Belle Fourche SD 57717-2215 | |
| (605) 892-3331 | |
| Not Available |
| Full Name | Maverick Health Care, Prof. Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2200 13th Ave, Belle Fourche, South Dakota |
| Authorized Official Name and Position | Helen Anne Kuehlman (MEDICAL DIRECTOR / OWNER OF LLC) |
| Authorized Official Contact | 8155314028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maverick Health Care, Prof. Llc 2625 Maverick Ct Spearfish SD 57783-9702 Ph: (815) 531-4028 | Maverick Health Care, Prof. Llc 2200 13th Ave Belle Fourche SD 57717-2215 Ph: (605) 892-3331 |
| NPI Number | 1104559814 |
|---|---|
| Provider Enumeration Date | 07/08/2022 |
| Last Update Date | 07/18/2022 |
| Medicare PECOS PAC ID | 8527442540 |
|---|---|
| Medicare Enrollment ID | O20220825000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104559814 | NPI | - | NPPES |
| 1104559814 | Other | FAMILY MEDICINE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Helen Anne Kuehlman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932380003 PECOS PAC ID: 3375623945 Enrollment ID: I20140214001649 |
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