| Monument Health Lead-deadwood Hospital | |
|
61 Charles St Deadwood SD 57732-1303 | |
| (605) 722-6101 | |
| Not Available |
| Full Name | Monument Health Lead-deadwood Hospital |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 61 Charles St, Deadwood, South Dakota |
| Authorized Official Name and Position | Mark C Schmidt (PRESIDENT CUSTER LD-DWD HOSPITAL) |
| Authorized Official Contact | 6057176020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Monument Health Lead-deadwood Hospital Po Box 860013 Minneapolis MN 55486-0013 Ph: (605) 717-6000 | Monument Health Lead-deadwood Hospital 61 Charles St Deadwood SD 57732-1303 Ph: (605) 722-6101 |
| NPI Number | 1255377412 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 03/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255377412 | NPI | - | NPPES |
| 9010710 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 10535 (South Dakota) | Primary |
Monument Health Lead-deadwood Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 71 Charles St, Deadwood, SD 57732 Phone: 605-717-6431 Fax: 605-717-8033 | |
Lead Deadwood Regional Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 71 Charles St, Deadwood, SD 57732 Phone: 605-717-6431 | |
Monument Health Lead-deadwood Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 71 Charles St, Deadwood, SD 57732 Phone: 605-717-6431 Fax: 605-717-8033 | |
Lead-deadwood Regional Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 71 Charles St, Deadwood, SD 57732 Phone: 605-717-6431 Fax: 605-719-6470 |