Healthcare Provider Details

I. General information

NPI: 1659410009
Provider Name (Legal Business Name): COTEAU DES PRAIRIES HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 ORCHARD DR
SISSETON SD
57262-2398
US

IV. Provider business mailing address

205 ORCHARD DR
SISSETON SD
57262-2398
US

V. Phone/Fax

Practice location:
  • Phone: 605-698-7681
  • Fax: 605-698-3493
Mailing address:
  • Phone: 605-698-7681
  • Fax: 605-698-3493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number60020
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRAIG KANTOS
Title or Position: CEO
Credential:
Phone: 605-698-4601