Provider Demographics
NPI:1407819253
Name:SAME DAY SURGERY CENTER LLC
Entity Type:Organization
Organization Name:SAME DAY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS-RCRH
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-719-1430
Mailing Address - Street 1:651 CATHEDRAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7368
Mailing Address - Country:US
Mailing Address - Phone:605-719-5000
Mailing Address - Fax:
Practice Address - Street 1:651 CATHEDRAL DR
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7368
Practice Address - Country:US
Practice Address - Phone:605-719-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10581284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0108030Medicaid
SD5508030Medicaid
SD430093Medicare Oscar/Certification