1831299247 NPI number — SACRED HEART HEALTH SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831299247 NPI number — SACRED HEART HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SACRED HEART HEALTH SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AVERA SACRED HEART HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831299247
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 SUMMIT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YANKTON
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57078-3855
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-668-8103
Provider Business Mailing Address Fax Number:
605-668-8097

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 SUMMIT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YANKTON
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57078-3855
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-668-8103
Provider Business Practice Location Address Fax Number:
605-668-8097
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHWASINGER
Authorized Official First Name:
TIM
Authorized Official Middle Name:
L
Authorized Official Title or Position:
DIRECTOR, PATIENT ACCOUNTS
Authorized Official Telephone Number:
605-668-8103

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8U012 . This is a "BLUE CROSS - SWINGBED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0159760 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".




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