Provider Demographics
NPI:1942456330
Name:BENNETT COUNTY HOSPITAL AND NURSING HOME
Entity Type:Organization
Organization Name:BENNETT COUNTY HOSPITAL AND NURSING HOME
Other - Org Name:BENNETT COUNTY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-685-6622
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:SD
Mailing Address - Zip Code:57551-0070
Mailing Address - Country:US
Mailing Address - Phone:605-685-6622
Mailing Address - Fax:605-685-1166
Practice Address - Street 1:102 MAJOR ALLEN
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:SD
Practice Address - Zip Code:57551-0070
Practice Address - Country:US
Practice Address - Phone:605-685-6622
Practice Address - Fax:605-685-1166
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENNETT COUNTY HOSPITAL AND NURSING HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-18
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD437040Medicare Oscar/Certification