Healthcare Provider Details

I. General information

NPI: 1356483242
Provider Name (Legal Business Name): MOBRIDGE REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 10TH AVE W
MOBRIDGE SD
57601-1106
US

IV. Provider business mailing address

1401 10TH AVE W
MOBRIDGE SD
57601-1106
US

V. Phone/Fax

Practice location:
  • Phone: 605-845-3692
  • Fax: 605-845-8252
Mailing address:
  • Phone: 605-845-3692
  • Fax: 605-845-8252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number48404
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN AYOUB
Title or Position: CEO
Credential:
Phone: 605-845-3692