Organization
DOUGLAS COUNTY MEMORIAL HOSPITAL
Active
Parent organization
DOUGLAS COUNTY MEMORIAL HOSPITAL
Other names
PRAIRIE HEALTH CLINIC - STICKNEY
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOUGLAS COUNTY MEMORIAL HOSPITAL
Authorized official
MRS. NICOLE J NEUGEBAUER (CLINIC OFFICE MANAGER)
(605) 732-4508
Entity
Organization
Contact information
Practice address
301 MAIN STREET, STICKNEY, SD 57375-0014
(605) 732-4508
Mailing address
PO BOX 14, 301 MAIN STREET, STICKNEY, SD 57375-0014
(605) 732-4508
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43D1039717
CLIA NUMBER
SD
05
—
5340420
—
SD
Enumeration date
09/06/2006
Last updated
12/06/2011
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