Organization
FORT THOMPSON INDIAN HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADONNA M LONG (CHIEF EXECUTIVE OFFICER)
(605) 245-1500
Entity
Organization
Contact information
Practice address
HWY 34 & 47, FORT THOMPSON, SD 57339-0200
(605) 245-1500
(605) 245-2384
Mailing address
HWY 34 & 47, FORT THOMPSON, SD 57339-0200
(605) 245-1500
(605) 245-2384
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5549010
—
SD
Enumeration date
08/03/2006
Last updated
04/20/2008
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