Healthcare Provider Details

I. General information

NPI: 1801959218
Provider Name (Legal Business Name): FALL RIVER HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HIGHWAY 71 S
HOT SPRINGS SD
57747-8800
US

IV. Provider business mailing address

1201 HIGHWAY 71 S
HOT SPRINGS SD
57747-8800
US

V. Phone/Fax

Practice location:
  • Phone: 605-745-3159
  • Fax: 605-745-3957
Mailing address:
  • Phone: 605-745-3159
  • Fax: 605-745-3957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number2001676
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHELLY GARDNER
Title or Position: PHARMACIST
Credential:
Phone: 605-745-3159