Provider Demographics
NPI:1144276957
Name:SPEARFISH REGIONAL HOSPITAL
Entity type:Organization
Organization Name:SPEARFISH REGIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:GIESEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-719-8706
Mailing Address - Street 1:1445 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1552
Mailing Address - Country:US
Mailing Address - Phone:605-644-4170
Mailing Address - Fax:605-644-4198
Practice Address - Street 1:1445 NORTH AVE
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1552
Practice Address - Country:US
Practice Address - Phone:605-644-4170
Practice Address - Fax:605-644-4198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10566282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD40254Medicare ID - Type Unspecified