Provider Demographics
NPI:1194809210
Name:EUREKA COMMUNITY & BENEVOLENT HOSPITAL
Entity type:Organization
Organization Name:EUREKA COMMUNITY & BENEVOLENT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HIM/CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:RAILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-284-2661
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:SD
Mailing Address - Zip Code:57437-0517
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 J AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:SD
Practice Address - Zip Code:57437
Practice Address - Country:US
Practice Address - Phone:605-284-2661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
275N00000X
SD275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD43Z308Medicare Oscar/Certification
43Z308Medicare Oscar/Certification