Provider Demographics
NPI:1295991370
Name:COMPREHENSIVE BREAST CARE PC
Entity type:Organization
Organization Name:COMPREHENSIVE BREAST CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:REILAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-335-1952
Mailing Address - Street 1:PO BOX 5126
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5126
Mailing Address - Country:US
Mailing Address - Phone:605-335-1952
Mailing Address - Fax:605-373-9971
Practice Address - Street 1:911 E 20TH ST STE 400
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1046
Practice Address - Country:US
Practice Address - Phone:605-332-2240
Practice Address - Fax:605-332-1617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDDO0887OtherRAILROAD MEDIARE
SDDO0887OtherRAILROAD MEDIARE