Healthcare Provider Details

I. General information

NPI: 1093714073
Provider Name (Legal Business Name): SIOUXLAND SURGERY CENTER LIMITED LIABILITY PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N SIOUX POINT RD
DAKOTA DUNES SD
57049-5000
US

IV. Provider business mailing address

455 N SIOUX POINT RD
DAKOTA DUNES SD
57049-5327
US

V. Phone/Fax

Practice location:
  • Phone: 605-232-3332
  • Fax: 605-232-0854
Mailing address:
  • Phone: 605-217-7000
  • Fax: 605-217-7015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number10580
License Number StateSD

VIII. Authorized Official

Name: NICHOLAS CRAFTS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 832-729-4009