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107 13th St N New Rockford ND 58356-1518 | |
| (701) 786-1709 | |
| (701) 786-7121 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 107 13th St N, New Rockford, North Dakota |
| Authorized Official Name and Position | Kelley Shawn (ADMIN ASSIST/CREDENTIALING) |
| Authorized Official Contact | 7017861709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
107 12th St S Cooperstown ND 58425-4501 Ph: (701) 786-1709 | 107 13th St N New Rockford ND 58356-1518 Ph: (701) 786-1709 |
| NPI Number | 1992459721 |
|---|---|
| Provider Enumeration Date | 02/10/2022 |
| Last Update Date | 08/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992459721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
East Central Center For Exceptional Children Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16 S 8th St, New Rockford, ND 58356 Phone: 701-947-5015 |