Organization
ST. MICHAEL'S HOSPITAL, INC.
Active
Parent organization
ST. MICHAEL'S HOSPITAL, INC.
Other names
Bon Homme Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MICHAEL'S HOSPITAL, INC.
Authorized official
ASHLI DANILKO (CHIEF EXECUTIVE OFFICER)
(605) 589-2152
Entity
Organization
Contact information
Practice address
410 W 16TH AVE, TYNDALL, SD 57066-2318
(605) 589-4418
(605) 589-4428
Mailing address
410 W 16TH AVE, TYNDALL, SD 57066-2318
(605) 589-2218
(605) 589-2216
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
1001860
SD
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5154760001
MEDICARE DME POS REGION D
—
05
—
8504170
—
SD
Enumeration date
08/09/2005
Last updated
09/21/2020
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