Healthcare Provider Details

I. General information

NPI: 1740521962
Provider Name (Legal Business Name): RAPID CITY REGIONAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 5TH ST SUITE 240
RAPID CITY SD
57701-7363
US

IV. Provider business mailing address

PO BOX 7917
BELFAST ME
04915-7900
US

V. Phone/Fax

Practice location:
  • Phone: 605-341-3770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number10558
License Number StateSD

VIII. Authorized Official

Name: TIMOTHY H SUGHRUE
Title or Position: CHIEF EXECUTIVE OFFICER/RCRH RHN
Credential:
Phone: 605-719-8162