Healthcare Provider Details

I. General information

NPI: 1174590806
Provider Name (Legal Business Name): MONUMENT HEALTH NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 CHARLES ST
DEADWOOD SD
57732-1303
US

IV. Provider business mailing address

PO BOX 860013
MINNEAPOLIS MN
55486-0013
US

V. Phone/Fax

Practice location:
  • Phone: 605-717-6000
  • Fax: 605-717-6008
Mailing address:
  • Phone: 605-717-6000
  • Fax: 605-717-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number10535
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number10535
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MARK C SCHMIDT
Title or Position: PRESIDENT CUSTER LD-DWD HOSPITAL
Credential:
Phone: 605-717-6020