Organization
LOWER BRULE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GEORGIA AMIOTTE (CEO)
(605) 473-5526
Entity
Organization
Contact information
Practice address
601 GALL STREET, LOWER BRULE, SD 57548-0247
(605) 473-5526
Mailing address
PO BOX 247, 601 GALL STREET, LOWER BRULE, SD 57548-0247
(605) 473-5526
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
04161983
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04161983
A.S.C.P.
SD
Enumeration date
03/28/2007
Last updated
08/22/2020
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