CHEYENNE RIVER BREAST & CERVICAL CANCER EARLY DETECTION PROGRAM NPI 1861120552

NPI Information

  • NPI: 1861120552
  • Provider Name: CHEYENNE RIVER BREAST & CERVICAL CANCER EARLY DETECTION PROGRAM
  • Classification: Clinic/Center - 261QR0206X
  • Specialization: Radiology, Mammography
  • Entity Type: Organization
  • Address: 24276 166TH ST
    EAGLE BUTTE, SD
    ZIP 57625
  • Phone: (605) 964-0736

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NPI Details

CHEYENNE RIVER BREAST & CERVICAL CANCER EARLY DETECTION PROGRAM is a radiology and mammography clinic center in Eagle Butte, SD. CHEYENNE RIVER BREAST & CERVICAL CANCER EARLY DETECTION PROGRAM NPI is 1861120552. The provider is registered as an organization entity type.

The provider's business location address is:

24276 166TH ST
EAGLE BUTTE, SD
ZIP 57625-141
Phone: (605) 964-0736
Fax: (605) 964-1176

The provider's authorized official is Ramona Simon .
The authorized official title is Tribal Health Ceo and has the following contact phone number (605) 964-0785.

The enumeration date for this NPI number is 8/10/2022 and was last updated on 8/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterNo
2261QR0206XClinic/CenterRadiology, MammographyYes

What is NPI?

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This page was last updated on: 11/21/2025

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