Organization Name: | RAPID CITY MEDICAL CENTER LLP |
NPI Number: | 1033121355 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARREL RIDDLE (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 2201 Jackson Blvd Rapid City |
State: | SD US |
Postal Code: | 577024386 |
Phone Number: | 6053484645 |
Fax Number: | |
NPI Enumeration Date: | 08/13/2006 |
NPI Last Update Date: | 11/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |