# PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
- **Other names:** Wanblee Health Center, PINE RIDGE INDIAN HEALTH SERVICES
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962559518
- **Legal business name:** PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
- **Authorized official:** RHONDA M AKERS (HEALTH SYSTEM SPECIALIST)
- **Authorized official phone:** (605) 867-3032

## Contact information

- **Practice address:** 210 1ST ST, WANBLEE, SD 57577-0290
- **Practice address phone:** (605) 462-6155
- **Practice address fax:** (605) 462-6631
- **Mailing address:** PO BOX 290, 210 1ST ST, WANBLEE, SD 57577-0290
- **Mailing address phone:** (605) 462-6155
- **Mailing address fax:** (605) 462-6631

## Taxonomy

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

## Other

- **Enumeration date:** 01/05/2007
- **Last updated:** 09/29/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 430098 | CMS | — |
| 05 | — | 5540040 | — | SD |
| 01 | — | HSZU07 | MEDICARE PIN | — |