Healthcare Provider Details

I. General information

NPI: 1679635239
Provider Name (Legal Business Name): HURON REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 PRAIRIE AVE SW
DE SMET SD
57231-2285
US

IV. Provider business mailing address

PO BOX 160
DE SMET SD
57231-0160
US

V. Phone/Fax

Practice location:
  • Phone: 605-854-3329
  • Fax:
Mailing address:
  • Phone: 605-854-3329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number50726
License Number StateSD

VIII. Authorized Official

Name: JOHN L SINGLE
Title or Position: CEO
Credential:
Phone: 605-353-6200