1891043550 NPI number — SIOUX FALLS SPECIALTY HOSPITAL, LLP

Table of content: (NPI 1891043550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891043550 NPI number — SIOUX FALLS SPECIALTY HOSPITAL, LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SIOUX FALLS SPECIALTY HOSPITAL, LLP
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:
Provider Other Organization Name Type Code:
6
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:
1891043550
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
910 EAST 20TH STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57105-1012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-334-6730
Provider Business Mailing Address Fax Number:
605-334-8096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4928 N CLIFF AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57104-0563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-444-8820
Provider Business Practice Location Address Fax Number:
605-444-8821
Provider Enumeration Date:
08/28/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CURD
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
BLAKE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
605-334-6730

Provider Taxonomy Codes

  • Taxonomy code: 284300000X , with the licence number:  10583 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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