Organization
BLACKHILLS DIALYSIS, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS C RAYMOND M.D (MEDICAL DIRECTOR)
(605) 964-2311
Entity
Organization
Contact information
Practice address
MAIN STREET, EAGLE BUTTE, SD 57625
(605) 964-2311
(605) 964-2313
Mailing address
MAIN STREET, EAGLE BUTTE, SD 57625
(605) 964-2311
(605) 964-2313
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5400370
—
SD
Enumeration date
07/18/2007
Last updated
02/02/2024
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