Provider Demographics
NPI:1154606119
Name:PEOPLES MARKET
Entity type:Organization
Organization Name:PEOPLES MARKET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-837-2232
Mailing Address - Street 1:905 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:KADOKA
Mailing Address - State:SD
Mailing Address - Zip Code:57543
Mailing Address - Country:US
Mailing Address - Phone:605-837-2232
Mailing Address - Fax:605-837-2334
Practice Address - Street 1:905 MAIN STREET
Practice Address - Street 2:
Practice Address - City:KADOKA
Practice Address - State:SD
Practice Address - Zip Code:57543
Practice Address - Country:US
Practice Address - Phone:605-837-2232
Practice Address - Fax:605-837-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care