Provider Demographics
NPI:1679635239
Name:HURON REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:HURON REGIONAL MEDICAL CENTER
Other - Org Name:DESMET MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SINGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-353-6200
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:DE SMET
Mailing Address - State:SD
Mailing Address - Zip Code:57231-0160
Mailing Address - Country:US
Mailing Address - Phone:605-854-3329
Mailing Address - Fax:
Practice Address - Street 1:306 PRAIRIE AVE SW
Practice Address - Street 2:
Practice Address - City:DE SMET
Practice Address - State:SD
Practice Address - Zip Code:57231-2285
Practice Address - Country:US
Practice Address - Phone:605-854-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD50726275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD43Z332Medicare Oscar/Certification