Provider Demographics
NPI:1972575173
Name:CITY OF REDFIELD
Entity Type:Organization
Organization Name:CITY OF REDFIELD
Other - Org Name:REDFIELD CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SJURSETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-472-1110
Mailing Address - Street 1:PO BOX 590
Mailing Address - Street 2:
Mailing Address - City:REDFIELD
Mailing Address - State:SD
Mailing Address - Zip Code:57469-0590
Mailing Address - Country:US
Mailing Address - Phone:605-472-0510
Mailing Address - Fax:605-472-0331
Practice Address - Street 1:1010 W 1ST ST
Practice Address - Street 2:
Practice Address - City:REDFIELD
Practice Address - State:SD
Practice Address - Zip Code:57469-1506
Practice Address - Country:US
Practice Address - Phone:605-472-0510
Practice Address - Fax:605-472-0331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS2712Medicare PIN
SD433404Medicare Oscar/Certification