Organization
BLACK HILLS REGIONAL EYE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI J SUDRALA CPA (CHIEF FINANCIAL OFFICER)
(605) 341-2000
Entity
Organization
Contact information
Practice address
2800 3RD ST, RAPID CITY, SD 57701-7374
(605) 341-2000
(605) 341-0278
Mailing address
2800 3RD ST, RAPID CITY, SD 57701-7374
(605) 341-2000
(605) 341-0278
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
100
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9200655
—
SD
Enumeration date
11/24/2006
Last updated
08/22/2020
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