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DSH430077AF Monument Health Rapid City Hospital (Active)
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Main Details
Name
Monument Health Rapid City Hospital
Subdivision Name
MONUMENT HEALTH RAPID CITY CLINIC - FAIRMONT BLVD - GASTROENTEROLOGY - GASTROENTEROLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH430077AF
Medicare Provider Number
430077
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/7/2025
Participating Start Date
4/1/2025
Participating Approval Date
2/3/2025
Last Recertification Date
Contacts
Authorizing Official
Monument Health
Ruta Paulette Davidson, President & CEO
(605) 755-9130
Primary Contact
Monument Health
Ryan Olivier, 340B Manager
(605) 366-6099
Addresses
Street Address
353 Fairmont Blvd
Rapid City, SD 57701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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