| Mobridge Regional Hospital | |
| 
					906 Main St Timber Lake SD 57656  | |
| (605) 865-3258 | |
| Not Available | 
| Full Name | Mobridge Regional Hospital | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 906 Main St, Timber Lake, South Dakota | 
| Authorized Official Name and Position | Renae Tisdall (CFO) | 
| Authorized Official Contact | 6058458164 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mobridge Regional Hospital Po Box 206 Timber Lake SD 57656-0206 Ph: (605) 865-3258  | Mobridge Regional Hospital 906 Main St Timber Lake SD 57656 Ph: (605) 865-3258  | 
| NPI Number | 1841267341 | 
|---|---|
| Provider Enumeration Date | 03/02/2006 | 
| Last Update Date | 10/06/2016 | 
| Medicare PECOS PAC ID | 6507776135 | 
|---|---|
| Medicare Enrollment ID | O20090209000192 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1841267341 | NPI | - | NPPES | 
| 5341010 | Medicaid | SD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary | 
Missouri Breaks Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Hc 64 Box 52, Timber Lake, SD 57656 Phone: 605-964-3418 Fax: 605-934-3415  |