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General NPI Number Information
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NPI Number | 1659410009
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Entity Type | Organization
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Legal Business Name | COTEAU DES PRAIRIES HOSPITAL
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 205 ORCHARD DR
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City | SISSETON
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State | SD
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Zip | 57262-2398
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Country | US
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Telephone | 605-698-7681
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Fax | 605-698-3493
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Provider Business Mailing Address
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Address Line | 205 ORCHARD DR
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City | SISSETON
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State | SD
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Zip | 57262-2398
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Country | US
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Telephone | 605-698-7681
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Fax | 605-698-3493
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Authorized Official
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Title or Position | CEO
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Name | CRAIG KANTOS
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Credential |
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Telephone | 605-698-4601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 60020
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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