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General NPI Number Information
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NPI Number | 1174450464
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Entity Type | Organization
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Legal Business Name | STANDING ROCK SIOUX TRIBE
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 9305 HWY 24
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City | FORT YATES
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State | ND
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Zip | 58538-0522
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Country | US
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Telephone | 701-854-3856
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Fax | 701-854-7611
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Provider Business Mailing Address
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Address Line | PO BOX D
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City | FORT YATES
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State | ND
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Zip | 58538-0522
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Country | US
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Telephone | 701-391-7170
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Fax |
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Authorized Official
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Title or Position | THIRD PARTY BILLING SPECIALIST
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Name | SHANTELLE CRUZ
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Credential |
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Telephone | 701-391-7170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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