Healthcare Provider Details

I. General information

NPI: 1679544555
Provider Name (Legal Business Name): FALL RIVER HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HWY 71 SOUTH
HOT SPRINGS SD
57747-1374
US

IV. Provider business mailing address

1201 HWY 71 SOUTH
HOT SPRINGS SD
57747-1374
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 Number47569
License Number StateSD

VIII. Authorized Official

Name: JOHN B MILLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 605-745-3159