Healthcare Provider Details
I. General information
NPI: 1992656706
Provider Name (Legal Business Name): BLACK HILLS SURGICAL HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3024 TOWER RD
RAPID CITY SD
57701-5392
US
IV. Provider business mailing address
PO BOX 5074
SIOUX FALLS SD
57117-5074
US
V. Phone/Fax
- Phone: 605-791-6220
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TONY
LEE
MORRISON
Title or Position: CHIEF REVENUE CYCLE OFFICER
Credential:
Phone: 605-328-8380