Organization
BLACK HILLS VISION CARE PROF LLC
Active
Other names
Black Hills Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E TRIMBLE OD (OWNER)
(605) 892-2020
Entity
Organization
Contact information
Practice address
1830 5TH AVE, BELLE FOURCHE, SD 57717-2089
(605) 892-4171
Mailing address
1830 5TH AVE, BELLE FOURCHE, SD 57717-2089
(605) 892-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T128
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000480182
—
MT
01
—
0075127
BC/BS
SD
05
—
112944900
—
WY
01
—
429
DAKOTACARE
SD
05
—
9201762
—
SD
Enumeration date
10/22/2007
Last updated
12/24/2009
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