Provider Demographics
NPI:1619344405
Name:MONUMENT HEALTH NETWORK, INC.
Entity Type:Organization
Organization Name:MONUMENT HEALTH NETWORK, INC.
Other - Org Name:MONUMENT HEALTH STURGIS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT SPEARFISH HOSPITAL HILLS
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:WORSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-644-4091
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:605-720-2600
Mailing Address - Fax:605-755-7884
Practice Address - Street 1:2140 JUNCTION AVE
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785
Practice Address - Country:US
Practice Address - Phone:605-720-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONUMENT HEALTH NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-27
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD214518OtherADCES
SD1619344405OtherNPI