| Organization Name: | CHEYENNE RIVER SIOUX TRIBE |
| NPI Number: | 1659530707 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIETTA L LITTLE THUNDER (COORDINATOR) |
| Mailing Address: | Highway 212 And Jefferson Street Diabetes Office Eagle Butte |
| State: | SD US |
| Postal Code: | 576250590 |
| Phone Number: | 6059644843 |
| Fax Number: | 6059641176 |
| NPI Enumeration Date: | 06/04/2008 |
| NPI Last Update Date: | 06/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 20-001-=========E-ST |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |