# BLACK HILLS FAMILY PRACTICE CLINIC PS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467542399
- **Authorized official:** DR. EDWARD R MACKE MD (PRESIDENT)
- **Authorized official phone:** (360) 495-3475

## Contact information

- **Practice address:** 332 S BIRCH ST, MCCLEARY, WA 98557-9522
- **Practice address phone:** (360) 495-3475
- **Mailing address:** PO BOX 68, MCCLEARY, WA 98557-0068
- **Mailing address phone:** (360) 495-3475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 10/13/2014