# SHADOW ANESTHESIA SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871807206
- **Authorized official:** MS. HOLLY VICTORIA LASHMET CRNA (CHIEF)
- **Authorized official phone:** (605) 845-3502

## Contact information

- **Practice address:** 1401 10TH AVE W, MOBRIDGE, SD 57601
- **Practice address phone:** (605) 845-8271
- **Practice address fax:** (605) 845-3502
- **Mailing address:** 403 10TH ST E, MOBRIDGE, SD 57601-1813
- **Mailing address phone:** (402) 802-0246
- **Mailing address fax:** (605) 845-3502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 100997 | NE | — |
| 282N00000X | General Acute Care Hospital | 100997 | NE | — |
| 282NC0060X | Critical Access Hospital | 100997 | NE | — |
| 282NC0060X | Critical Access Hospital | 55417 | KS | — |
| 282NR1301X | Rural Acute Care Hospital | CR000953 | SD | Yes |

## Other

- **Enumeration date:** 07/27/2010
- **Last updated:** 07/16/2018