Healthcare Provider Details

I. General information

NPI: 1033273818
Provider Name (Legal Business Name): RAPID CITY REGIONAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 FAIRMONT BLVD
RAPID CITY SD
57701-7375
US

IV. Provider business mailing address

353 FAIRMONT BLVD PO BOX 3450
RAPID CITY SD
57701-7375
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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number10558
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number1000535
License Number StateSD

VIII. Authorized Official

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