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Organization
LOWER BRULE HEALTH CENTER IHS
Active
Organization
LOWER BRULE HEALTH CENTER IHS
Active
Other names
Lower Brule Indian Health Service
Organization subpart
No
Provider details
NPI number
Authorized official
EYVONNE T REKOW (CHIEF EXECUTIVE OFFICER)
(605) 473-5526
Entity
Organization
Contact information
Practice address
601 GALL STREET, LOWER BRULE, SD 57548-0248
(605) 473-5526
(605) 473-0828
Mailing address
PO BOX 248, 601 GALL STREET, LOWER BRULE, SD 57548-0248
(605) 473-5526
(605) 473-0828
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4304882
NABP
SD
05
—
5549020
—
SD
01
—
HSZ133
MEDICARE INDENTIFIER
SD
Enumeration date
03/20/2007
Last updated
12/22/2016
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