Organization
HENDRICKS COMMUNITY HOSPITAL ASSOCIATION
Active
Other names
White Family Practice Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF GOLLAHER (CEO)
(507) 275-3134
Entity
Organization
Contact information
Practice address
302 EAST FIFTH STREET, WHITE, SD 57276
(605) 629-8211
(605) 629-8291
Mailing address
PO BOX 106, HENDRICKS, MN 56136-0106
(507) 275-3134
(507) 275-2242
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
11137
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5306792
—
SD
Enumeration date
11/01/2006
Last updated
08/22/2020
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