Provider Demographics
NPI:1487096509
Name:BLACK HILLS URGENT CARE LLC
Entity type:Organization
Organization Name:BLACK HILLS URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:URGENT CARE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KONST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-791-7777
Mailing Address - Street 1:1730 HAINES AVE
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-0983
Mailing Address - Country:US
Mailing Address - Phone:605-791-7788
Mailing Address - Fax:605-791-7755
Practice Address - Street 1:1730 HAINES AVE
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-0983
Practice Address - Country:US
Practice Address - Phone:605-791-7788
Practice Address - Fax:605-791-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care