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General NPI Number Information
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NPI Number | 1962559518
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Entity Type | Organization
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Legal Business Name | PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 210 1ST ST
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City | WANBLEE
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State | SD
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Zip | 57577-0290
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Country | US
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Telephone | 605-462-6155
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Fax | 605-462-6631
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Provider Business Mailing Address
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Address Line | PO BOX 290 210 1ST ST
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City | WANBLEE
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State | SD
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Zip | 57577-0290
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Country | US
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Telephone | 605-462-6155
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Fax | 605-462-6631
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Authorized Official
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Title or Position | HEALTH SYSTEM SPECIALIST
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Name | RHONDA M AKERS
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Credential |
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Telephone | 605-867-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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