Organization
PINE RIDGE INDIAN HEALTH SERVICE
Active
Parent organization
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Other names
Wanblee Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Authorized official
RHONDA M AKERS (HEALTH SYSTEMS SPECIALIST)
(605) 867-3032
Entity
Organization
Contact information
Practice address
210 1ST ST, WANBLEE, SD 57577
(605) 462-6155
Mailing address
PO BOX 1201, PINE RIDGE, SD 57770-1201
(605) 867-5131
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430098
CCN
—
05
—
5540040
—
SC
Enumeration date
12/21/2007
Last updated
07/29/2020
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