CHEYENNE RIVER BREAST & CERVICAL CANCER EARLY DETECTION PROGRAM NPI 1861120552

NPI Information

NPI: 1861120552
Provider Name: CHEYENNE RIVER BREAST & CERVICAL CANCER EARLY DETECTION PROGRAM
Classification: Clinic/Center - 261QR0206X
Entity Type: Organization

Specialization: Radiology, Mammography

Address:
24276 166TH ST
EAGLE BUTTE, SD
ZIP 57625
Phone: (605) 964-0736
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CHEYENNE RIVER BREAST & CERVICAL CANCER EARLY DETECTION PROGRAM is a radiology and mammography clinic center in Eagle Butte, SD. CHEYENNE RIVER BREAST & CERVICAL CANCER EARLY DETECTION PROGRAM NPI is 1861120552. The provider is registered as an organization entity type.

The provider's business location address is:

24276 166TH ST
EAGLE BUTTE, SD
ZIP 57625-141
Phone: (605) 964-0736
Fax: (605) 964-1176

The provider's authorized official is Ramona Simon .
The authorized official title is Tribal Health Ceo and has the following contact phone number (605) 964-0785.

The enumeration date for this NPI number is 8/10/2022 and was last updated on 8/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center				No
2	261QR0206X	Clinic/Center	Radiology, Mammography			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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