Healthcare Provider Details

I. General information

NPI: 1255477162
Provider Name (Legal Business Name): COTEAU DES PRAIRIES HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 WEST BROADWAY
BROWNS VALLEY MN
56219
US

IV. Provider business mailing address

205 ORCHARD DR
SISSETON SD
57262-2398
US

V. Phone/Fax

Practice location:
  • Phone: 320-695-2526
  • Fax: 320-695-2106
Mailing address:
  • Phone: 605-698-7681
  • Fax: 605-698-3493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number60020
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number60020
License Number StateSD

VIII. Authorized Official

Name: CRAIG KANTOS
Title or Position: CEO
Credential:
Phone: 605-698-4601