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ST. BENEDICT HEALTH CENTER NPI 1114931797


NPI Information

NPI: 1114931797
Provider Name: ST. BENEDICT HEALTH CENTER

Doing Business As: AVERA ST. BENEDICT CERTIFIED RURAL HEALTH CLINIC, LAKE ANDES

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 43D0698570

Address:
756 EAST LAKE STREET
LAKE ANDES, SD
ZIP 57356
Phone: (605) 487-7878
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ST. BENEDICT HEALTH CENTER is a rural health clinic center in Lake Andes, SD. ST. BENEDICT HEALTH CENTER NPI is 1114931797. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera St. Benedict Certified Rural Health Clinic, Lake Andes.

The provider's business location address is:

756 EAST LAKE STREET
LAKE ANDES, SD
ZIP 57356
Phone: (605) 487-7878
Fax: (605) 487-9566

The provider's authorized official is Lindsay R Weber .
The authorized official title is Ceo and has the following contact phone number (605) 928-3311.

The CLIA number assigned to this NPI record is 43D0698570 - rural health clinic with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 11/30/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2261QR1300XClinic/CenterRural HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15340060MEDICAIDSOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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