Organization
BLACK HILLS REGIONAL EYE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI J ANDERSON CPA (CHIEF FINANCIAL OFFICER)
(605) 341-2000
Entity
Organization
Contact information
Practice address
2800 3RD ST, RAPID CITY, SD 57701-7374
(605) 341-2000
(605) 719-3211
Mailing address
2800 3RD ST, RAPID CITY, SD 57701-7374
(605) 341-2000
(605) 719-3211
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
11143
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5490052
—
SD
Enumeration date
01/18/2006
Last updated
12/28/2007
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