Provider Demographics
NPI:1881340503
Name:CITY OF STURGIS
Entity type:Organization
Organization Name:CITY OF STURGIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:HALLI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-347-5801
Mailing Address - Street 1:1901 BALLPARK RD
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:SD
Mailing Address - Zip Code:57785-3128
Mailing Address - Country:US
Mailing Address - Phone:605-347-5801
Mailing Address - Fax:605-347-2558
Practice Address - Street 1:1901 BALLPARK RD
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-3128
Practice Address - Country:US
Practice Address - Phone:605-347-5801
Practice Address - Fax:605-347-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9017122Medicaid