Organization
REGIONAL HEALTH
Active
Other names
Lead-Deadwood Regional Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI MATTHEW (CLINIC ADMINISTRATOR)
(605) 717-6431
Entity
Organization
Contact information
Practice address
71 CHARLES ST, DEADWOOD, SD 57732-1303
(605) 717-6431
(605) 719-6470
Mailing address
71 CHARLES ST, DEADWOOD, SD 57732-1303
(605) 717-6431
(605) 719-6470
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
42-005-460372453E
SD
291U00000X
Clinical Medical Laboratory
—
SD
Other
Enumeration date
06/02/2006
Last updated
12/26/2007
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