Organization
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Active
Parent organization
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Other names
Wanblee Health Center, PINE RIDGE INDIAN HEALTH SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Authorized official
RHONDA M AKERS (HEALTH SYSTEM SPECIALIST)
(605) 867-3032
Entity
Organization
Contact information
Practice address
210 1ST ST, WANBLEE, SD 57577-0290
(605) 462-6155
(605) 462-6631
Mailing address
PO BOX 290, 210 1ST ST, WANBLEE, SD 57577-0290
(605) 462-6155
(605) 462-6631
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430098
CMS
—
05
—
5540040
—
SD
01
—
HSZU07
MEDICARE PIN
—
Enumeration date
01/05/2007
Last updated
09/29/2022
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