Organization
REHABILITATION MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JENSEN (DIRECTOR OF OPERATIONS)
(605) 444-9711
Entity
Organization
Contact information
Practice address
1020 W. 18TH STREET, SIOUX FALLS, SD 57104
(605) 444-9702
(605) 444-9701
Mailing address
1020 W. 18TH STREET, SIOUX FALLS, SD 57104
(605) 444-9702
(605) 444-9701
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9167012
—
SD
Enumeration date
09/16/2006
Last updated
10/29/2020
Update your record
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