Healthcare Provider Details
I. General information
NPI: 1700718541
Provider Name (Legal Business Name): SOUTH DAKOTA LIONS EYE & TISSUE BANK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4501 W 61ST ST N
SIOUX FALLS SD
57107-6411
US
IV. Provider business mailing address
4501 W 61ST ST N
SIOUX FALLS SD
57107-6411
US
V. Phone/Fax
- Phone: 605-373-1008
- Fax:
- Phone: 605-373-1008
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332G00000X |
| Taxonomy | Eye Bank |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATTHEW
ARNETT
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 605-373-1008