Provider Demographics
NPI:1801273537
Name:MONUMENT HEALTH NETWORK, INC.
Entity type:Organization
Organization Name:MONUMENT HEALTH NETWORK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CUSTER LDWD MARKET
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-755-8094
Mailing Address - Street 1:PO BOX 860013
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0013
Mailing Address - Country:US
Mailing Address - Phone:605-755-7649
Mailing Address - Fax:605-755-7884
Practice Address - Street 1:1220 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:CUSTER
Practice Address - State:SD
Practice Address - Zip Code:57730-1705
Practice Address - Country:US
Practice Address - Phone:605-673-9400
Practice Address - Fax:605-755-0694
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONUMENT HEALTH NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-01
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1801273537OtherNPI NUMBER
SD214518OtherADCES