Provider Demographics
NPI:1679544555
Name:FALL RIVER HEALTH SERVICES
Entity type:Organization
Organization Name:FALL RIVER HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-745-3159
Mailing Address - Street 1:1201 HWY 71 SOUTH
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57747-1374
Mailing Address - Country:US
Mailing Address - Phone:605-745-3159
Mailing Address - Fax:605-745-3957
Practice Address - Street 1:1201 HWY 71 SOUTH
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:SD
Practice Address - Zip Code:57747-1374
Practice Address - Country:US
Practice Address - Phone:605-745-3159
Practice Address - Fax:605-745-3957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD47569282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0100320Medicaid
SD5500320Medicaid
SD81322OtherWELLMARK
SD431322Medicare ID - Type UnspecifiedHOSPTIAL
SDS6192Medicare PIN