# LEWIS & CLARK SPECIALTY HOSPITAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LEWIS & CLARK SPECIALTY HOSPITAL LLC
- **Other names:** Lewis & Clark Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134471527
- **Legal business name:** LEWIS & CLARK SPECIALTY HOSPITAL LLC
- **Authorized official:** MR. DOUG DOORN (CEO)
- **Authorized official phone:** (605) 665-5100

## Contact information

- **Practice address:** 2525 FOX RUN PARKWAY, STE 200, YANKTON, SD 57078-5371
- **Practice address phone:** (605) 260-2100
- **Practice address fax:** (605) 665-5200
- **Mailing address:** 2525 FOX RUN PARKWAY, STE 200, YANKTON, SD 57078-5371
- **Mailing address phone:** (605) 260-2100
- **Mailing address fax:** (605) 665-5200

## Taxonomy

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

## Other

- **Enumeration date:** 10/09/2012
- **Last updated:** 04/23/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0108070 | — | SD |
| 01 | — | 430096 | MEDICARE | SD |
| 01 | — | 47834 | DEPARTMENT OF HEALTH | SD |
| 05 | — | 5508070 | — | SD |