Rushmore Dental Products, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RUSHMORE DENTAL PRODUCTS, INC.

Doing business as

Presidents Specialty Health Care Supplies

Practice address

712 Jackson Blvd
Suite #2
Rapid City, SD 57702-2554

Phone

(605) 341-4669

Fax

(605) 341-3413

NPI assigned

Jun 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Peggy Lee Coyne, RN, MN

Title

President & Ceo

Phone

(605) 341-4669

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Presidents Specialty Health Care Supplies Doing business as

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1508801291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 JACKSON BLVD",
            "address_2": "SUITE #2",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022554",
            "telephone_number": "605-341-4669",
            "fax_number": "605-341-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 JACKSON BLVD",
            "address_2": "SUITE #2",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022554",
            "telephone_number": "605-341-4669",
            "fax_number": "605-341-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSHMORE DENTAL PRODUCTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "COYNE",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "605-341-4669",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9165300",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presidents Specialty Health Care Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda Rush, MS, LPC, CCDCIII
• Tristen Rush, PT
• Rushmore Ambulatory Surgery Center (Black Hills Pediatric Dentistry Surgery Center)
• Rushmore Clinic, P.C.
• Rushmore Crossing Vision Center, LLC
• Rushmore Dermatology, LLP
• Rushmore Family Chiropractic, LLC
• Rushmore Heart Clinic LLC
• Rushmore Kids Speech Therapy Inc
• Rushmore OB-GYN PC

• Durable Medical Equipment & Medical Supplies in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Durable Medical Equipment & Medical Supplies in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.