Healthcare Provider Details

I. General information

NPI: 1659316214
Provider Name (Legal Business Name): PRAIRIE LAKES HEALTH CARE SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 9TH AVE NW
WATERTOWN SD
57201-1548
US

IV. Provider business mailing address

401 9TH AVE NW
WATERTOWN SD
57201-1548
US

V. Phone/Fax

Practice location:
  • Phone: 605-882-7000
  • Fax: 605-882-7607
Mailing address:
  • Phone: 605-882-7000
  • Fax: 605-882-7607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number10572
License Number StateSD

VIII. Authorized Official

Name: TONY LEE MORRISON
Title or Position: VICE PRESIDENT, REVENUE CYCLE
Credential:
Phone: 605-328-8380