Provider Demographics
NPI:1245295237
Name:HAND COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:HAND COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREITLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-853-0399
Mailing Address - Street 1:225 W 4TH ST APT 109
Mailing Address - Street 2:
Mailing Address - City:MILLER
Mailing Address - State:SD
Mailing Address - Zip Code:57362-1355
Mailing Address - Country:US
Mailing Address - Phone:605-853-0364
Mailing Address - Fax:605-853-0327
Practice Address - Street 1:225 W 4TH ST APT 109
Practice Address - Street 2:
Practice Address - City:MILLER
Practice Address - State:SD
Practice Address - Zip Code:57362-1355
Practice Address - Country:US
Practice Address - Phone:605-853-0364
Practice Address - Fax:605-853-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD40288310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9570260Medicaid
SDS30031Medicare PIN
SD431337Medicare ID - Type UnspecifiedINPATIENT OUTPATIENT