Provider Demographics
NPI:1477281459
Name:ARGO, SAMSON USHA
Entity Type:Individual
Prefix:
First Name:SAMSON
Middle Name:USHA
Last Name:ARGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 S TOWNSLEY AVE UNIT 107
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-7640
Mailing Address - Country:US
Mailing Address - Phone:605-370-0974
Mailing Address - Fax:
Practice Address - Street 1:7701 S TOWNSLEY AVE UNIT 107
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-7640
Practice Address - Country:US
Practice Address - Phone:605-370-0974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD80011311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD88-3623207Medicaid