Provider Demographics
NPI:1407306038
Name:MONUMENT HEALTH HOME PLUS, LLC
Entity Type:Organization
Organization Name:MONUMENT HEALTH HOME PLUS, LLC
Other - Org Name:MONUMENT HEALTH HOME PLUS HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-MONUMENT HEALTH HOME PLUS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TILLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-519-1179
Mailing Address - Street 1:PO BOX 860013
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0013
Mailing Address - Country:US
Mailing Address - Phone:605-755-7649
Mailing Address - Fax:605-755-9010
Practice Address - Street 1:1800 HAINES AVE
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-0616
Practice Address - Country:US
Practice Address - Phone:605-755-9000
Practice Address - Fax:605-755-9010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONUMENT HEALTH HOME PLUS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-06
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies