Provider Demographics
NPI:1407835697
Name:OSTEOPOROSIS SCREENING CENTER
Entity Type:Organization
Organization Name:OSTEOPOROSIS SCREENING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ENGELBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-343-2176
Mailing Address - Street 1:343 QUINCY ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-3797
Mailing Address - Country:US
Mailing Address - Phone:605-343-2176
Mailing Address - Fax:605-342-7612
Practice Address - Street 1:343 QUINCY ST
Practice Address - Street 2:SUITE 105
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-3797
Practice Address - Country:US
Practice Address - Phone:605-343-2176
Practice Address - Fax:605-342-7612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4999796OtherBCBS GROUP #
NE=========13Medicaid
NE=========13Medicaid