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General NPI Number Information
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NPI Number | 1528017662
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Entity Type | Organization
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Legal Business Name | PIONEER MEMORIAL HOSPITAL &HEALTH SERVICES
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 513 BROADWAY ST
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City | CENTERVILLE
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State | SD
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Zip | 57014-2236
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Country | US
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Telephone | 605-563-2411
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Fax | 605-563-2060
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Provider Business Mailing Address
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Address Line | PO BOX 368
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City | VIBORG
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State | SD
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Zip | 57070-0368
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Country | US
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Telephone | 605-326-5161
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Fax | 605-326-5734
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ISAAC GERDES
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Credential |
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Telephone | 605-326-5161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | SD
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