| Organization Name: | EAGLE BUTTE INDIAN HEALTH SERVICE HOSPITAL |
| NPI Number: | 1558395848 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUSTIN J KECKLER (ACTING CEO) |
| Mailing Address: | 24276 166th Street Airport Road Eagle Butte |
| State: | SD US |
| Postal Code: | 576251012 |
| Phone Number: | 6059647724 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 02/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |