Healthcare Provider Details

I. General information

NPI: 1962479600
Provider Name (Legal Business Name): RAPID CITY REGIONAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 ELK STREET
RAPID CITY SD
57701-7359
US

IV. Provider business mailing address

PO BOX 3450
RAPID CITY SD
57709-3450
US

V. Phone/Fax

Practice location:
  • Phone: 605-719-1000
  • Fax: 605-719-4499
Mailing address:
  • Phone: 605-719-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier9550002
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer
# 2
Identifier81501
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerWELLMARK

VIII. Authorized Official

Name: TIMOTHY SUGHRUE
Title or Position: CEO-RCRH EXECUTIVE MANAGEMENT
Credential:
Phone: 605-719-8162