| Pine Ridge Indian Health Service Hospital | |
|
101 Main Street Porcupine SD 57772 | |
| (605) 867-5131 | |
| Not Available |
| Full Name | Pine Ridge Indian Health Service Hospital |
|---|---|
| Speciality | Clinic/center |
| Location | 101 Main Street, Porcupine, South Dakota |
| Authorized Official Name and Position | William J Pourier (CEO) |
| Authorized Official Contact | 6058673021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Ridge Indian Health Service Hospital P.o. Box 1201 Pine Ridge SD 57770-0275 Ph: (605) 867-5131 | Pine Ridge Indian Health Service Hospital 101 Main Street Porcupine SD 57772 Ph: (605) 867-5131 |
| NPI Number | 1033266945 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 01/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033266945 | NPI | - | NPPES |
| 5540260 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |