Healthcare Provider Details

I. General information

NPI: 1184821787
Provider Name (Legal Business Name): RAPID CITY AREA SCHOOL DISTRICT 51-4
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 6TH ST
RAPID CITY SD
57701-5034
US

IV. Provider business mailing address

300 6TH ST
RAPID CITY SD
57701-5034
US

V. Phone/Fax

Practice location:
  • Phone: 605-394-4026
  • Fax: 605-394-1816
Mailing address:
  • Phone: 605-394-4026
  • Fax: 605-394-1816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. DAVID B JANAK
Title or Position: BUSINESS MANAGER
Credential:
Phone: 605-394-4026