Organization
RUSHMORE CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKY L KRAUSE (CLINIC MANAGER)
(605) 718-7450
Entity
Organization
Contact information
Practice address
101 E MINNESOTA ST, SUITE 260, RAPID CITY, SD 57701-7756
(605) 718-7450
(605) 718-7465
Mailing address
101 E MINNESOTA ST, SUITE 260, RAPID CITY, SD 57701-7756
(605) 718-7450
(605) 718-7465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1584
SD
363A00000X
Physician Assistant
0348
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040192
BLUE CROSS BLUE SHIELD
SD
05
—
10025296700
—
NE
01
—
2944830
WY WORKERS SAFETY
WY
01
—
3522835001
OWCP
—
01
—
40192
SECURE HORIZONS
SD
01
—
9202253
CAREWEST
SD
Enumeration date
12/29/2006
Last updated
04/20/2008
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