Provider Demographics
NPI:1740376441
Name:MOREAU-GRAND ELECTRIC COOPERATIVE, INC
Entity type:Organization
Organization Name:MOREAU-GRAND ELECTRIC COOPERATIVE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-865-3511
Mailing Address - Street 1:405 9TH ST
Mailing Address - Street 2:PO BOX 8
Mailing Address - City:TIMBER LAKE
Mailing Address - State:SD
Mailing Address - Zip Code:57656-0008
Mailing Address - Country:US
Mailing Address - Phone:605-865-3511
Mailing Address - Fax:605-865-3340
Practice Address - Street 1:405 9TH ST
Practice Address - Street 2:
Practice Address - City:TIMBER LAKE
Practice Address - State:SD
Practice Address - Zip Code:57656-0008
Practice Address - Country:US
Practice Address - Phone:605-865-3511
Practice Address - Fax:605-865-3340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9560490OtherDEPT OF SOCIAL SERVICES