Provider Demographics
NPI:1720026222
Name:LANDMANN JUNGMAN MEMORIAL HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:LANDMANN JUNGMAN MEMORIAL HOSPITAL CORPORATION
Other - Org Name:LANDMANN JUNGMAN MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-583-2226
Mailing Address - Street 1:600 BILLARS ST
Mailing Address - Street 2:
Mailing Address - City:SCOTLAND
Mailing Address - State:SD
Mailing Address - Zip Code:57059-2026
Mailing Address - Country:US
Mailing Address - Phone:605-583-2226
Mailing Address - Fax:605-583-4557
Practice Address - Street 1:600 BILLARS ST
Practice Address - Street 2:
Practice Address - City:SCOTLAND
Practice Address - State:SD
Practice Address - Zip Code:57059-2026
Practice Address - Country:US
Practice Address - Phone:605-583-2226
Practice Address - Fax:605-583-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10561282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD43Z317Medicare Oscar/Certification
SD431510Medicare ID - Type UnspecifiedHOSPICE
SD431317Medicare Oscar/Certification
SD437048Medicare ID - Type UnspecifiedHOME HEALTH