Provider Demographics
NPI:1245516780
Name:SIOUX FALLS SPECIALTY HOSPITAL LLP
Entity type:Organization
Organization Name:SIOUX FALLS SPECIALTY HOSPITAL LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:CURD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-334-6730
Mailing Address - Street 1:910 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1012
Mailing Address - Country:US
Mailing Address - Phone:605-334-6730
Mailing Address - Fax:605-334-8096
Practice Address - Street 1:716 E 19TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0904
Practice Address - Country:US
Practice Address - Phone:605-444-8650
Practice Address - Fax:605-444-8651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD10583284300000X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD430090Medicare UPIN