Organization
BLACK HILLS DIALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS C. RAYMOND M.D. (MEDICAL DIRECTOR)
(605) 390-2929
Entity
Organization
Contact information
Practice address
100 DIALYSIS DRIVE, PINE RIDGE, SD 57770-3013
(605) 867-5983
(605) 867-6153
Mailing address
801 MT. RUSHMORE ROAD, SUITE 202, RAPID CITY, SD 57701-3541
(605) 718-0391
(605) 718-0392
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5400380
—
SD
Enumeration date
09/22/2006
Last updated
11/07/2014
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