Healthcare Provider Details

I. General information

NPI: 1942243274
Provider Name (Legal Business Name): MOBRIDGE REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/19/2025
Certification Date:
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: 605-845-3693
  • Fax: 605-845-8263
Mailing address:
  • Phone: 605-845-3693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number100-0973
License Number StateSD

VIII. Authorized Official

Name: DIANE DADY
Title or Position: PHARMACY DIR
Credential: RPH
Phone: 605-845-8140