Organization
LOWER BRULE HEALTH CENTER IHS
Active
Other names
Lower Brule Indian Health Service
Organization subpart
No
Provider details
NPI number
Authorized official
EYVONNE T REKOW (CHIEF EXECUTIVE OFFICER)
(605) 473-5526
Entity
Organization
Contact information
Practice address
601 GALL STREET, LOWER BRULE, SD 57548-0248
(605) 473-5526
(605) 473-0828
Mailing address
PO BOX 248, 601 GALL STREET, LOWER BRULE, SD 57548-0248
(605) 473-5526
(605) 473-0828
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4304882
NABP
SD
05
—
5549020
—
SD
01
—
HSZ133
MEDICARE INDENTIFIER
SD
Enumeration date
03/20/2007
Last updated
12/22/2016
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