Healthcare Provider Details

I. General information

NPI: 1972779957
Provider Name (Legal Business Name): MONUMENT HEALTH NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 13TH AVE
BELLE FOURCHE SD
57717-2215
US

IV. Provider business mailing address

PO BOX 860013
MINNEAPOLIS MN
55486-0013
US

V. Phone/Fax

Practice location:
  • Phone: 605-723-8961
  • Fax:
Mailing address:
  • Phone: 605-723-8961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number10566
License Number StateSD

VIII. Authorized Official

Name: THOMAS WORSLEY
Title or Position: PRESIDENT SPEARFISH HOSPITAL
Credential:
Phone: 605-644-4091