Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 95 2nd St Nw, Beach, North Dakota |
Authorized Official Name and Position | Reed Reyman (PRESIDENT) |
Authorized Official Contact | 7014564000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
95 2nd St Nw Beach ND 58621-0940 Ph: (701) 872-3777 | 95 2nd St Nw Beach ND 58621-0940 Ph: (701) 872-3777 |
NPI Number | 1669491262 |
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Provider Enumeration Date | 07/18/2006 |
Last Update Date | 03/29/2018 |
Medicare PECOS PAC ID | 0547177560 |
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Medicare Enrollment ID | O20020819000008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669491262 | NPI | - | NPPES |
1460324 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 5054A (North Dakota) | Primary |