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Organization

COUNTY OF JERAULD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHANNON FAGERHAUG (JERAULD COUNTY AUDITOR)
(605) 539-9301
Entity
Organization

Contact information

Practice address
604 1ST ST NE, WESSINGTON SPRINGS, SD 57382-2166
(605) 539-1201
(605) 539-4580
Mailing address
604 1ST ST NE, WESSINGTON SPRINGS, SD 57382-2166
(605) 539-1201
(605) 539-4580

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0099040
BC BS
SD
05
9000530
SD
01
S99040
MEDICARE PROVIDER#
SD
Enumeration date
01/18/2006
Last updated
11/23/2022
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