Pine Ridge Indian Health Service Hospital | |
101 Main Street Porcupine SD 57772 | |
(605) 867-5131 | |
Not Available |
Full Name | Pine Ridge Indian Health Service Hospital |
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Speciality | Clinic/center |
Location | 101 Main Street, Porcupine, South Dakota |
Authorized Official Name and Position | William J Pourier (CEO) |
Authorized Official Contact | 6058673021 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pine Ridge Indian Health Service Hospital P.o. Box 1201 Pine Ridge SD 57770-0275 Ph: (605) 867-5131 | Pine Ridge Indian Health Service Hospital 101 Main Street Porcupine SD 57772 Ph: (605) 867-5131 |
NPI Number | 1033266945 |
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Provider Enumeration Date | 01/04/2007 |
Last Update Date | 01/13/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033266945 | NPI | - | NPPES |
5540260 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |