Provider Demographics
NPI:1730123522
Name:ST MICHAEL'S HOSPITAL, INC.
Entity Type:Organization
Organization Name:ST MICHAEL'S HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLI
Authorized Official - Middle Name:
Authorized Official - Last Name:DANILKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-589-2152
Mailing Address - Street 1:410 W 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:TYNDALL
Mailing Address - State:SD
Mailing Address - Zip Code:57066-2318
Mailing Address - Country:US
Mailing Address - Phone:605-589-2100
Mailing Address - Fax:605-589-2115
Practice Address - Street 1:410 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:TYNDALL
Practice Address - State:SD
Practice Address - Zip Code:57066-2318
Practice Address - Country:US
Practice Address - Phone:605-589-2100
Practice Address - Fax:605-589-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD48584282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0100370Medicaid
SD5590250Medicaid
SD5500370Medicaid
SD5500370Medicaid