Organization
PIONEER MEMORIAL HOSPITAL &HEALTH SERVICES
Active
Other names
Centerville Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC GERDES (CHIEF EXECUTIVE OFFICER)
(605) 326-5161
Entity
Organization
Contact information
Practice address
513 BROADWAY ST, CENTERVILLE, SD 57014-2236
(605) 563-2411
(605) 563-2060
Mailing address
PO BOX 368, VIBORG, SD 57070-0368
(605) 326-5161
(605) 326-5734
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4993935
BLUE CROSS BLUE SHIELD
SD
05
—
5340280
—
SD
Enumeration date
05/08/2006
Last updated
10/20/2025
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