Provider Demographics
NPI:1003818006
Name:FREEMAN REGIONAL HEALTH SERVICES
Entity Type:Organization
Organization Name:FREEMAN REGIONAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-925-4000
Mailing Address - Street 1:510 EAST 8TH STREET
Mailing Address - Street 2:PO BOX 370
Mailing Address - City:FREEMAN
Mailing Address - State:SD
Mailing Address - Zip Code:57029
Mailing Address - Country:US
Mailing Address - Phone:605-925-4000
Mailing Address - Fax:605-925-2137
Practice Address - Street 1:510 EAST 8TH STREET
Practice Address - Street 2:BOX 370
Practice Address - City:FREEMAN
Practice Address - State:SD
Practice Address - Zip Code:57029
Practice Address - Country:US
Practice Address - Phone:605-925-4000
Practice Address - Fax:605-925-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10541282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5500360Medicaid
SD8Z313OtherBLUE CROSS SWINGBED
SD0100360Medicaid
SD0159060Medicaid
SD85112OtherBLUE CROSS SNF
SD81313OtherBLUE CROSS
SD0100360Medicaid
SD8Z313OtherBLUE CROSS SWINGBED
SD431313Medicare Oscar/Certification
SD431313Medicare PIN
SD5500360Medicaid