| Coal Country Community Health Center | |
|
150 Central Ave N Killdeer ND 58640-4018 | |
| (701) 764-5822 | |
| Not Available |
| Full Name | Coal Country Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 150 Central Ave N, Killdeer, 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 150 Central Ave Killdeer ND 58640-4018 Ph: (701) 764-5822 | Coal Country Community Health Center 150 Central Ave N Killdeer ND 58640-4018 Ph: (701) 764-5822 |
| NPI Number | 1407235575 |
|---|---|
| Provider Enumeration Date | 05/22/2015 |
| Last Update Date | 12/08/2016 |
| Medicare PECOS PAC ID | 9436042892 |
|---|---|
| Medicare Enrollment ID | O20150909002323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407235575 | NPI | - | NPPES |
| 1464996 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Killdeer Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Central Ave N, Killdeer, ND 58640 Phone: 701-764-5822 Fax: 701-764-5304 |