Organization
WALL HEALTH SERVICES, INC.
Active
Other names
Wall Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTER JOHANNESEN (CLINIC COORDINATOR)
(605) 279-2149
Entity
Organization
Contact information
Practice address
112 7TH AVE, WALL, SD 57790-0423
(605) 279-2149
(605) 279-2139
Mailing address
PO BOX 423, WALL, SD 57790-0423
(605) 279-2149
(605) 279-2139
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4999946
BCBS # FOR WALL CLINIC
SD
05
—
5300040
—
SD
Enumeration date
11/17/2005
Last updated
03/25/2008
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