Provider Demographics
NPI:1952473233
Name:SOUTH DAKOTA URBAN INDIAN HEALTH, INC. SDUIH
Entity Type:Organization
Organization Name:SOUTH DAKOTA URBAN INDIAN HEALTH, INC. SDUIH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-224-8841
Mailing Address - Street 1:1200 N WEST AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1335
Mailing Address - Country:US
Mailing Address - Phone:605-339-0420
Mailing Address - Fax:605-339-0038
Practice Address - Street 1:1200 N WEST AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-1335
Practice Address - Country:US
Practice Address - Phone:605-339-0420
Practice Address - Fax:605-339-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4997460OtherBCBS OF SD GROUP PIN
SD5350183Medicaid
SD4997460OtherBCBS OF SD GROUP PIN