Organization
CHEYENNE RIVER SIOUX TRIBE DIABETES CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RAMONA SIMON RN (TRIBAL HEALTH CEO)
(605) 964-0785
Entity
Organization
Contact information
Practice address
24276 166TH STREET AIRPORT ROAD, EAGLE BUTTE, SD 57625-0590
(605) 964-0788
(605) 964-1062
Mailing address
PO BOX 590, EAGLE BUTTE, SD 57625-0590
(605) 964-0788
(605) 964-1062
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5546290
—
SD
Enumeration date
02/07/2014
Last updated
08/10/2022
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