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100 1st Ave Se Kenmare ND 58746-7329 | |
(701) 226-0926 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 100 1st Ave Se, Kenmare, North Dakota |
Authorized Official Name and Position | Shelley Bartow (PRESIDENT) |
Authorized Official Contact | 7013853020 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 755 Kenmare ND 58746-0755 Ph: () - | 100 1st Ave Se Kenmare ND 58746-7329 Ph: (701) 226-0926 |
NPI Number | 1487268611 |
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Provider Enumeration Date | 09/04/2020 |
Last Update Date | 09/01/2021 |
Medicare PECOS PAC ID | 6608255633 |
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Medicare Enrollment ID | O20220622002678 |
Identifier | Type | State | Issuer |
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1487268611 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |