1629172739 NPI number — CITY OF RAPID CITY

Table of content: (NPI 1629172739)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629172739 NPI number — CITY OF RAPID CITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF RAPID CITY
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:
1629172739
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAPID CITY
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57701-2832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-394-4180
Provider Business Mailing Address Fax Number:
605-394-5145

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAPID CITY
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57701-2832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-394-4180
Provider Business Practice Location Address Fax Number:
605-394-5145
Provider Enumeration Date:
09/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CULBERSON
Authorized Official First Name:
JASON
Authorized Official Middle Name:
N
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
605-394-4180

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  020 , 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: 2556961 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10024996000 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4770469 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100505512 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 120722900 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 310193600 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0041055 . This is a "WELLMARK BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0589481 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9011200 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00009677 . This is a "PALMETTO RAILROAD MC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 440922000 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 80449900 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 806068607 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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