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Organization
HURON LABORATORY SVC PC
Active
Organization
HURON LABORATORY SVC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY VAN WINKLE (PRESIDENT)
(605) 940-6410
Entity
Organization
Contact information
Practice address
172 4TH ST SE, HURON, SD 57350-2510
(605) 353-6200
(952) 442-3620
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005771
BLUE CROSS SD
SD
01
—
220023870
RAILROAD MEDICARE
SD
05
—
6600320
—
SD
Enumeration date
06/22/2005
Last updated
12/29/2016
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