Organization
RAPID CITY IHS HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH EDWARD FERBER MT(AAB) (MEDICAL TECHNOLOGIST)
(605) 355-2230
Entity
Organization
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2230
(605) 355-2514
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(605) 355-2230
(605) 355-2514
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
18757 MT(AAB)
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140070
—
SD
01
—
5549050
MEDICAID
SD
Enumeration date
02/23/2010
Last updated
02/23/2010
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