# PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033266945
- **Legal business name:** PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
- **Authorized official:** WILLIAM J POURIER (CEO)
- **Authorized official phone:** (605) 867-3021

## Contact information

- **Practice address:** 101 MAIN STREET, PORCUPINE, SD 57772
- **Practice address phone:** (605) 867-5131
- **Mailing address:** P.O. BOX 1201, PINE RIDGE, SD 57770-0275
- **Mailing address phone:** (605) 867-5131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/04/2007
- **Last updated:** 01/13/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5540260 | — | SD |