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NPI Code Detail

MEDICARE: BLACK HILLS HEARING HEALTH

MEDICARE: BLACK HILLS HEARING HEALTH
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
1231H00000XAudiologist010ASD

Other Identifiers

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

General Provider Information

NPI Number : 1891006425
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLACK HILLS HEARING HEALTH
Provider Business Mailing Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5462
Country : US
Telephone Number : 605-388-5781
Fax Number : 605-721-8439
Provider Business Practice Location Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5462
Country : US
Telephone Number : 605-388-5781
Fax Number :
Authorized Official
Title or Position : DOCTOR OF AUDIOLOGIST
Name : NANCY MARIE GWALTNEY
Credential : AUD
Telephone Number : 605-388-5781
Provider Enumeration Date : 06/29/2010
Last Update Date : 06/29/2010

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Directions to “BLACK HILLS HEARING HEALTH ” Practice Location

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