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General NPI Number Information
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NPI Number | 1487878435
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEMORIAL HOSPITAL INC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 809 JACKSON ST
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City | BURKE
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State | SD
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Zip | 57523-0319
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Country | US
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Telephone | 605-775-2621
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Fax |
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Provider Business Mailing Address
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Address Line | 809 JACKSON ST
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City | BURKE
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State | SD
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Zip | 57523-0319
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Country | US
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Telephone | 605-775-2621
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISTIE SACHTJEN
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Credential |
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Telephone | 605-775-2621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number | 10530
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License Number State | SD
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