Provider Demographics
NPI:1215575097
Name:EUREKA COMMUNITY & BENEVOLENT HOSPITAL
Entity Type:Organization
Organization Name:EUREKA COMMUNITY & BENEVOLENT HOSPITAL
Other - Org Name:EUREKA MEDICAL CLINIC AVERA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HIM
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:RAILE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:605-284-2661
Mailing Address - Street 1:PO BOX 487
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:SD
Mailing Address - Zip Code:57437-0487
Mailing Address - Country:US
Mailing Address - Phone:605-284-2661
Mailing Address - Fax:605-284-2054
Practice Address - Street 1:200 J AVE STE A
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:SD
Practice Address - Zip Code:57437-2225
Practice Address - Country:US
Practice Address - Phone:605-284-2621
Practice Address - Fax:605-284-2623
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EUREKA COMMUNITY & BENEVOLENT HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-12
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center