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Organization
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Active
Organization
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Active
Parent organization
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Authorized official
WILLIAM J POURIER (CEO)
(605) 867-3021
Entity
Organization
Contact information
Practice address
101 MAIN STREET, PORCUPINE, SD 57772
(605) 867-5131
Mailing address
P.O. BOX 1201, PINE RIDGE, SD 57770-0275
(605) 867-5131
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5540260
—
SD
Enumeration date
01/04/2007
Last updated
01/13/2011
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