Provider Demographics
NPI:1164471819
Name:HAND COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HAND COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREITLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-853-2421
Mailing Address - Street 1:300 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MILLER
Mailing Address - State:SD
Mailing Address - Zip Code:57362-1238
Mailing Address - Country:US
Mailing Address - Phone:605-853-2421
Mailing Address - Fax:605-853-0333
Practice Address - Street 1:300 W 5TH ST
Practice Address - Street 2:
Practice Address - City:MILLER
Practice Address - State:SD
Practice Address - Zip Code:57362-1238
Practice Address - Country:US
Practice Address - Phone:605-853-2421
Practice Address - Fax:605-853-0333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAND COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-09
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD53862314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD43Z337Medicare Oscar/Certification