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Organization

MOBRIDGE REGIONAL HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RENAE TISDALL (CFO)
(605) 845-8164
Entity
Organization

Contact information

Practice address
1401 10TH AVE WEST, MOBRIDGE, SD 57601-0850
(605) 845-3692
(605) 845-8252
Mailing address
PO BOX 580, MOBRIDGE, SD 57601-0580
(605) 845-3692
(605) 845-8252

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
48404
SD
282NC0060X
Critical Access Hospital
Primary
48404
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5500400
SD
01
81325
BCBS OF SOUTH DAKOTA
SD
Enumeration date
03/31/2006
Last updated
10/06/2016
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