| Mcintosh Community Clinic | |
|
208 W Main Street Mcintosh SD 57641-0195 | |
| (605) 273-4335 | |
| (605) 273-4360 |
| Full Name | Mcintosh Community Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 208 W Main Street, Mcintosh, South Dakota |
| Authorized Official Name and Position | John Mengenhausen (AUTHORIZED OFFICIAL CEO) |
| Authorized Official Contact | 6057724525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcintosh Community Clinic Po Box 195 Mc Intosh SD 57641-0195 Ph: (605) 273-4335 | Mcintosh Community Clinic 208 W Main Street Mcintosh SD 57641-0195 Ph: (605) 273-4335 |
| NPI Number | 1609842665 |
|---|---|
| Provider Enumeration Date | 02/28/2006 |
| Last Update Date | 02/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609842665 | NPI | - | NPPES |
| 5350260 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |