Organization
EAGLE BUTTE INDIAN HEALTH SERVICE HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN J KECKLER (ACTING CEO)
(605) 964-7724
Entity
Organization
Contact information
Practice address
24276 166TH STREET, AIRPORT ROAD, EAGLE BUTTE, SD 57625-1012
(605) 964-7724
Mailing address
24276 166TH STREET AIRPORT ROAD, EAGLE BUTTE, SD 57625-1012
(605) 964-7724
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5549080
—
SD
Enumeration date
07/10/2006
Last updated
02/21/2012
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