Cheyenne River Breast & Cervical Cancer Early Detection Program

NPI #1861120552 in Eagle Butte, South Dakota

Provider Information

NPI Number: 1861120552
Entity Type: Organization
Organization Name: Cheyenne River Breast & Cervical Cancer Early Detection Program
Subpart: Yes (part of a larger organization)
Parent Organization: CHEYENNE RIVER SIOUX TRIBE FIELD HEALTH CLINIC
Primary Specialty: Clinic/Center - Radiology, Mammography
Enumeration Date: Aug 10, 2022
Last Updated: Aug 11, 2022

Practice Location

Address: 24276 166TH ST
City: Eagle Butte
State: South Dakota
ZIP Code: 57625-8141
Phone: (605) 964-0736

Authorized Official

Name: RAMONA SIMON, RN
Title: TRIBAL HEALTH CEO
Phone: (605) 964-0785

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X
Clinic/Center - Radiology, Mammography — Radiology, Mammography	261QR0206X	Primary

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