| Coal Country Community Health Center | |
|
510 8th Ave Nw Hazen ND 58545-4638 | |
| (701) 748-2257 | |
| (701) 749-2257 |
| Full Name | Coal Country Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 8th Ave Nw, Hazen, North Dakota |
| Authorized Official Name and Position | Darrold Bertsch (CEO) |
| Authorized Official Contact | 7018734445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coal Country Community Health Center 1312 Highway 49 N Beulah ND 58523-6038 Ph: (701) 873-4445 | Coal Country Community Health Center 510 8th Ave Nw Hazen ND 58545-4638 Ph: (701) 748-2257 |
| NPI Number | 1841658887 |
|---|---|
| Provider Enumeration Date | 02/05/2016 |
| Last Update Date | 04/21/2017 |
| Medicare PECOS PAC ID | 9436042892 |
|---|---|
| Medicare Enrollment ID | O20160504001608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841658887 | NPI | - | NPPES |
| 1468309 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Sakakawea Hazen Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 517 8th Ave Ne, Hazen, ND 58545 Phone: 701-748-2256 Fax: 701-748-2257 | |
Sakakawea Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 510 8th Ave Ne, Hazen, ND 58545 Phone: 701-748-2225 Fax: 701-639-4343 | |
Surge Fitness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Highway Dr, Hazen, ND 58545 Phone: 701-748-3334 |