PIONEER MEMORIAL HOSPITAL &HEALTH SERVICES (NPI# 1528017662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528017662 |
| Entity Type | Organization |
| Organization Name | PIONEER MEMORIAL HOSPITAL &HEALTH SERVICES |
| Other Organization Name | CENTERVILLE MEDICAL CLINIC |
| Practice Address |
512 Broadway Centerville SD 57014-0070 |
| Mailing Address |
Po Box 368 Viborg SD 57070-0368 |
| Practice Telephone | 6055632411 |
| Practice Fax Number | 6055632060 |
| Mailing Telephone | 6053265161 |
| Mailing Fax Number | 6053265734 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2012-01-04 |
| Authorized Official Name | GEORGIA POKORNEY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6053265161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
SD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | BLUE CROSS BLUE SHIELD | 4993935 | 01 |
| SD | 5340280 | 05 |
| Other Name | Type Code |
|---|---|
| Centerville Medical Clinic | Doing Business As Name - Organization |
| Street Address |
512 BROADWAY |
| City | CENTERVILLE |
| State | SD |
| Zip Code | 57014-0070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417284928 | Candace L Verdoorn | Nurse Practitioner | 512 Broadway, Centerville, SD 57014-0070 | 2009-11-05 |
| 1043313950 | Lavonne Isaak | Pharmacy Technician | 512 Broadway, Centerville, SD 57014-0070 | 2006-09-06 |
| 1508969569 | Cody D Carstensen | Pharmacist | 512 Broadway, Centerville, SD 57014 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477081743 | Lewis Family Drug, LLC | Pharmacy | 513 Broadway St, Centerville, SD 57014 | 2017-05-31 |
| 1003956202 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 500 Vermillion St, Centerville, SD 57014 | 2007-02-07 |
| 1518062629 | Pioneer Memorial Hospital and Health Services | Pharmacy | 513 Broadway, Centerville, SD 57014 | 2006-09-13 |
| 1134129836 | Centerville Community Ambulance Service, Inc. | Ambulance | 800 Main Street, Box 181, Centerville, SD 57014-0181 | 2005-07-26 |
| 1922023944 | Justin Delzer | Chiropractor | 540 Broadway, Centerville, SD 57014-0271 | 2006-07-12 |
| 1407181001 | Centerville School District 60-01 | Local Education Agency (LEA) | 610 Lincoln St, Centerville, SD 57014-2040 | 2009-10-15 |
| 1720605397 | Bruce Adam Bennett | Registered Nurse | 610 Lincoln St, Centerville, SD 57014-2040 | 2020-06-30 |
| 1790137834 | Nichole Johnson | Speech-Language Pathologist | 610 Lincoln St, Centerville, SD 57014-2040 | 2016-07-12 |
| 1881684637 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 500 Vermillion St, Centerville, SD 57014-2168 | 2005-10-24 |
| 1760042329 | Justine Katherine Sanderson | Occupational Therapy Assistant | 500 Vermillion St, Centerville, SD 57014-2168 | 2019-06-17 |
| Find all providers in zip 57014 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1558529206 | Mercy Medical Center-centerville | Clinic/Center | 19876 St. Joseph's Drive, Centerville, IA 52544 | 2008-05-29 |
| 1255414744 | St. Joseph Regional Health Center | Clinic/Center | 102 West Main St., Centerville, TX 75833 | 2006-10-20 |
| 1992718688 | Saint Thomas Hickman Hospital | Clinic/Center | 150 E Swan Street, Centerville, TN 37033 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447803432 | City of Brookings | Clinic/Center | 104 1/2 West 2nd Street, Elkton, SD 57026 | 2019-07-19 |
| 1477942878 | Platte Community Memorial Hospital, Inc | Clinic/Center | 306 S Johnston St, White Lake, SD 57383-2251 | 2015-01-22 |
| 1003230541 | Regional Health Physicians, Inc. | Clinic/Center | 112 7th Avenue, Wall, SD 57790 | 2014-02-04 |
| 1912279829 | City of Brookings | Clinic/Center | 302 E 5th Street, White, SD 57276-2061 | 2012-02-08 |
| 1902187032 | Community Memorial Hospital Inc | Clinic/Center | 314 Mellette St, Bonesteel, SD 57317 | 2011-09-02 |
| 1609013317 | Douglas County Memorial Hospital | Clinic/Center | 310 W Sd Highway 46, Wagner, SD 57380-9304 | 2009-01-16 |
| 1750422655 | Regional Health Physicians Inc | Clinic/Center | 114 E Main Street, Hill City, SD 57745 | 2007-02-12 |
| 1326189754 | Regional Health Physicians Inc | Clinic/Center | 101 E. Third St., Newell, SD 57760 | 2007-02-09 |
| 1609931518 | Sioux Valley Clinic | Clinic/Center | 600 W Cedar Street (highway 46), Beresford, SD 57004 | 2006-12-22 |
| 1588677892 | Avera Mckennan | Clinic/Center | 305 N 2nd Ave, Revillo, SD 57259-0006 | 2006-08-15 |
| Find all providers with the same taxonomy | ||||
| City | CENTERVILLE |
| Zip Code | 57014 |
Please comment or provide details below to improve the information on PIONEER MEMORIAL HOSPITAL &HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.