Organization
SACRED HEART RURAL HEALTH CLINICS
Active
Organization
SACRED HEART RURAL HEALTH CLINICS
Active
Other names
Avera Medical Group Niobrara
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAM REZAC (PRESIDENT/CEO)
(605) 668-8322
Entity
Organization
Contact information
Practice address
25410 PARK AVE, APARTMENT E, NIOBRARA, NE 68760-7044
(402) 857-3398
(402) 857-3315
Mailing address
1000 W 4TH ST, SUITE 8, YANKTON, SD 57078-3730
(605) 655-1201
(605) 655-1210
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025008100
—
NE
01
—
921087
DAKOTACARE
NE
Enumeration date
10/02/2006
Last updated
02/07/2012
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