Healthcare Provider Details

I. General information

NPI: 1255415246
Provider Name (Legal Business Name): MONUMENT HEALTH RAPID CITY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 YANKEE ST
SPEARFISH SD
57783-2948
US

IV. Provider business mailing address

PO BOX 860013
MINNEAPOLIS MN
55486-0013
US

V. Phone/Fax

Practice location:
  • Phone: 605-644-9000
  • Fax:
Mailing address:
  • Phone: 605-722-8110
  • Fax: 605-722-8112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number10535
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JOHN PIERCE
Title or Position: PRESIDENT OF MONUMENT HEALTH
Credential:
Phone: 605-755-8162