Organization
WAGNER INDIAN HEALTH SERVICE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R HORNED EAGLE (CEO)
(605) 384-3621
Entity
Organization
Contact information
Practice address
111 WASHINGTON AVE NW, WAGNER, SD 57380-4300
(605) 384-3621
(605) 384-5497
Mailing address
111 WASHINGTON AVE NW, WAGNER, SD 57380-4300
(605) 384-3621
(605) 384-5497
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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