Healthcare Provider Details

I. General information

NPI: 1023003969
Provider Name (Legal Business Name): HEART HOSPITAL OF SOUTH DAKOTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 W 69TH ST
SIOUX FALLS SD
57108-8148
US

IV. Provider business mailing address

4500 W 69TH ST
SIOUX FALLS SD
57108-8148
US

V. Phone/Fax

Practice location:
  • Phone: 605-977-7000
  • Fax: 605-977-7001
Mailing address:
  • Phone: 605-977-7000
  • Fax: 605-977-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number41953
License Number StateSD

VIII. Authorized Official

Name: BRIAN PEDERSON
Title or Position: CFO
Credential:
Phone: 605-977-7009