Provider Demographics
NPI:1184788952
Name:WESTERN HILLS HEALTH CARE INC
Entity type:Organization
Organization Name:WESTERN HILLS HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:COOVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-342-5004
Mailing Address - Street 1:23064 THUNDERHEAD FALLS RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-8525
Mailing Address - Country:US
Mailing Address - Phone:605-342-1076
Mailing Address - Fax:605-342-5004
Practice Address - Street 1:23064 THUNDERHEAD FALLS RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8525
Practice Address - Country:US
Practice Address - Phone:605-342-1076
Practice Address - Fax:605-342-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD53001EST001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9566000Medicaid