Dakota Regional Medical Center | |
107 12th St S Cooperstown ND 58425-4501 | |
(701) 786-1709 | |
(701) 786-7121 |
Full Name | Dakota Regional Medical Center |
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Speciality | Clinic/Center |
Location | 107 12th St S, Cooperstown, North Dakota |
Authorized Official Name and Position | Kelley Shawn (ADMIN ASSIST/CREDENTIALING) |
Authorized Official Contact | 7017861709 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dakota Regional Medical Center 107 12th St S Cooperstown ND 58425-4501 Ph: (701) 786-1709 | Dakota Regional Medical Center 107 12th St S Cooperstown ND 58425-4501 Ph: (701) 786-1709 |
NPI Number | 1962548214 |
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Provider Enumeration Date | 01/30/2007 |
Last Update Date | 09/08/2023 |
Medicare PECOS PAC ID | 5698687689 |
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Medicare Enrollment ID | O20030929000016 |
Identifier | Type | State | Issuer |
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1962548214 | NPI | - | NPPES |
4770 | Other | ND | BLUE CROSS BLUE SHIELD |
5000 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |