Healthcare Provider Details

I. General information

NPI: 1730186073
Provider Name (Legal Business Name): PLATTE COMMUNITY MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 S MAIN ST
GEDDES SD
57342-1046
US

IV. Provider business mailing address

PO BOX 169
GEDDES SD
57342-0169
US

V. Phone/Fax

Practice location:
  • Phone: 605-337-3197
  • Fax: 605-337-3873
Mailing address:
  • Phone: 605-337-3197
  • Fax: 605-337-3873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number10557
License Number StateSD

VIII. Authorized Official

Name: MR. MARK A BURKET
Title or Position: CEO
Credential:
Phone: 605-337-3364