| Prairie View Medical, Prof. Llc | |
|
3405 6th St Ste 5 Brookings SD 57006-4401 | |
| (605) 695-6712 | |
| Not Available |
| Full Name | Prairie View Medical, Prof. Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3405 6th St Ste 5, Brookings, South Dakota |
| Authorized Official Name and Position | Jennifer Olson (PRESIDENT/CEO) |
| Authorized Official Contact | 6056937862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie View Medical, Prof. Llc 3405 6th St Ste 5 Brookings SD 57006-4401 Ph: (605) 693-7862 | Prairie View Medical, Prof. Llc 3405 6th St Ste 5 Brookings SD 57006-4401 Ph: (605) 695-6712 |
| NPI Number | 1508635772 |
|---|---|
| Provider Enumeration Date | 12/28/2023 |
| Last Update Date | 04/17/2024 |
| Medicare PECOS PAC ID | 4183063050 |
|---|---|
| Medicare Enrollment ID | O20240412000075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508635772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jennifer Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285623439 PECOS PAC ID: 7810945243 Enrollment ID: I20070226000300 |
| Provider Name | Jodi L Jung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609103977 PECOS PAC ID: 3476684671 Enrollment ID: I20100702000407 |
City Of Brookings Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 22nd Ave, Brookings, SD 57006 Phone: 605-697-9500 Fax: 605-697-6939 | |
Rural Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 22nd Ave Ste 1, Brookings, SD 57006 Phone: 605-697-9500 Fax: 605-697-9627 | |
Danielle Hohm, Fnp, Family Wellness Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 216 W 2nd St S, Brookings, SD 57006 Phone: 605-692-1772 Fax: 605-692-2353 | |
Dr. Chad D. Kalil, Optometrist P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2233 6th St, Brookings, SD 57006 Phone: 605-692-3595 | |
Avera Mckennan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 22nd Ave., Brookings, SD 57006 Phone: 605-697-9500 Fax: 605-697-6939 | |
City Of Brookings Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 22nd Avenue, Brookings, SD 57006 Phone: 605-696-9000 |