MEDICARE: MONUMENT HEALTH NETWORK, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	275N00000X	Medicare Defined Swing Bed Hospital Unit	10566	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861466898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONUMENT HEALTH NETWORK, INC.

Provider Business Mailing Address
First Line	:	PO BOX 860013
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55486-0013
Country	:	US
Telephone Number	:	605-644-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 N MAIN ST
Second Line	:
City	:	SPEARFISH
State	:	SD
Zip	:	57783-1505
Country	:	US
Telephone Number	:	605-644-4000
Fax Number	:	605-644-4247

Authorized Official
Title or Position	:	PRESIDENT SPEARFISH HOSPITAL
Name	:	THOMAS WORSLEY
Credential	:
Telephone Number	:	605-644-4091

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	03/16/2020

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