Organization
RAPID CITY INDIAN HEALTH SERVICE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEROY CLARK MD (CLINICAL DIRECTOR)
(605) 355-2423
Entity
Organization
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2500
(605) 355-2517
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2358
(605) 355-2517
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140070
—
SD
05
—
5549050
—
SD
Enumeration date
04/10/2006
Last updated
07/29/2010
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