Provider Demographics
NPI:1629152749
Name:EUREKA COMMUNITY & BENEVOLENT HOSPITAL
Entity Type:Organization
Organization Name:EUREKA COMMUNITY & BENEVOLENT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HIM
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-284-2661
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:SD
Mailing Address - Zip Code:57437-0517
Mailing Address - Country:US
Mailing Address - Phone:605-284-2661
Mailing Address - Fax:605-284-2054
Practice Address - Street 1:200 J AVE
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:605-228-6631
Practice Address - Fax:605-284-2054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10538282NC0060X
282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0100620Medicaid
SD55500620Medicaid
SD431308Medicare Oscar/Certification
SD437063Medicare Oscar/Certification
431308Medicare Oscar/Certification