Provider Demographics
NPI:1053388793
Name:RAPID CITY REGIONAL HOSPITAL INC
Entity type:Organization
Organization Name:RAPID CITY REGIONAL HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-RCRH EXECUTIVE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUGHRUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-719-8162
Mailing Address - Street 1:PO BOX 3450
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-3450
Mailing Address - Country:US
Mailing Address - Phone:605-719-1000
Mailing Address - Fax:
Practice Address - Street 1:224 ELK STREET
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7359
Practice Address - Country:US
Practice Address - Phone:605-719-1000
Practice Address - Fax:605-719-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 333300000X
SD10558253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No333300000XSuppliersEmergency Response System Companies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD87003OtherWELLMARK
SD0170180Medicaid
SD=========OtherTRICARE
SD=========OtherTRICARE