Healthcare Provider Details

I. General information

NPI: 1336009646
Provider Name (Legal Business Name): BLACK HILLS SURGICAL HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 HAINES AVE
RAPID CITY SD
57701-0615
US

IV. Provider business mailing address

PO BOX 817
RAPID CITY SD
57709-0817
US

V. Phone/Fax

Practice location:
  • Phone: 605-791-7788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
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: TONY LEE MORRISON
Title or Position: VP, CHIEF REVENUE CYCLE OFFICER
Credential:
Phone: 605-328-8380