=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003818006
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FREEMAN REGIONAL HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/10/2005
-----------------------------------------------------
Last Update Date | 01/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 510 EAST 8TH STREET BOX 370
-----------------------------------------------------
City | FREEMAN
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-925-4000
-----------------------------------------------------
Fax | 605-925-2137
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 510 EAST 8TH STREET PO BOX 370
-----------------------------------------------------
City | FREEMAN
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-925-4000
-----------------------------------------------------
Fax | 605-925-2137
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | PHILLIP LEE HUSHER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 605-925-2112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NC0060X
-----------------------------------------------------
Taxonomy Name | Critical Access Hospital
-----------------------------------------------------
License Number | 10541
-----------------------------------------------------
License Number State | SD
-----------------------------------------------------