Healthcare Provider Details

I. General information

NPI: 1528017662
Provider Name (Legal Business Name): PIONEER MEMORIAL HOSPITAL &HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 BROADWAY ST
CENTERVILLE SD
57014-2236
US

IV. Provider business mailing address

PO BOX 368
VIBORG SD
57070-0368
US

V. Phone/Fax

Practice location:
  • Phone: 605-563-2411
  • Fax: 605-563-2060
Mailing address:
  • Phone: 605-326-5161
  • Fax: 605-326-5734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateSD

VIII. Authorized Official

Name: ISAAC GERDES
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 605-326-5161