| Pine Ridge Indian Health Service | |
|
210 1st St Wanblee SD 57577 | |
| (605) 462-6155 | |
| Not Available |
| Full Name | Pine Ridge Indian Health Service |
|---|---|
| Speciality | Clinic/center |
| Location | 210 1st St, Wanblee, South Dakota |
| Authorized Official Name and Position | Rhonda M Akers (HEALTH SYSTEMS SPECIALIST) |
| Authorized Official Contact | 6058673032 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Ridge Indian Health Service Po Box 1201 Pine Ridge SD 57770-1201 Ph: (605) 867-5131 | Pine Ridge Indian Health Service 210 1st St Wanblee SD 57577 Ph: (605) 462-6155 |
| NPI Number | 1548444862 |
|---|---|
| Provider Enumeration Date | 12/21/2007 |
| Last Update Date | 07/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548444862 | NPI | - | NPPES |
| 5540040 | Medicaid | SC | |
| 430098 | Other | CCN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Pine Ridge Indian Health Service Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 1st St, Wanblee, SD 57577 Phone: 605-462-6155 Fax: 605-462-6631 |