Provider Demographics
NPI:1740521962
Name:RAPID CITY REGIONAL HOSPITAL INC
Entity type:Organization
Organization Name:RAPID CITY REGIONAL HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/RCRH RHN
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUGHRUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-719-8162
Mailing Address - Street 1:PO BOX 7917
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-7900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2929 5TH ST
Practice Address - Street 2:SUITE 240
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7363
Practice Address - Country:US
Practice Address - Phone:605-341-3770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAPID CITY REGIONAL HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10558261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD430077Medicare Oscar/Certification