Organization Name: | IHS EAGLE BUTTE |
NPI Number: | 1497046767 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHLEEN IONE RED DOG (NURSE) |
Mailing Address: | 317 S. Main St. Eagle Butte |
State: | SD US |
Postal Code: | 576251012 |
Phone Number: | 6059642814 |
Fax Number: | |
NPI Enumeration Date: | 04/21/2011 |
NPI Last Update Date: | 04/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 282NR1301X |
License Number: | R039790 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | General Acute Care Hospital |
Taxonomy Specialization: | Rural |
Taxonomy Definition: |