Garrison Family Clinic | |
437 3rd Ave Se Garrison ND 58540-7235 | |
(701) 463-2245 | |
(701) 463-6543 |
Full Name | Garrison Family Clinic |
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Speciality | Clinic/Center |
Location | 437 3rd Ave Se, Garrison, North Dakota |
Authorized Official Name and Position | Tod S Graeber (ADMINISTRATOR) |
Authorized Official Contact | 7014636505 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Garrison Family Clinic 437 3rd Ave Se Po Box 9 Garrison ND 58540-7235 Ph: (701) 463-2245 | Garrison Family Clinic 437 3rd Ave Se Garrison ND 58540-7235 Ph: (701) 463-2245 |
NPI Number | 1952381873 |
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Provider Enumeration Date | 01/18/2006 |
Last Update Date | 10/07/2014 |
Medicare PECOS PAC ID | 0143206946 |
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Medicare Enrollment ID | O20040624000556 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952381873 | NPI | - | NPPES |
17125 | Medicaid | ND | |
9555 | Other | ND | BLUE CROSS/BLUE SHIELD |
5083 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Jon E Dornacker |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801804588 PECOS PAC ID: 2466400312 Enrollment ID: I20050106000874 |
Provider Name | Ashley L Murrey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619108420 PECOS PAC ID: 7416002530 Enrollment ID: I20090825000778 |
Provider Name | Cassandra B Haider |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750698585 PECOS PAC ID: 3173716644 Enrollment ID: I20101018000692 |
Provider Name | Forrest L Hirsch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437645306 PECOS PAC ID: 6507117280 Enrollment ID: I20180919000903 |
Provider Name | Elizabeth Ashley Diffely |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245914563 PECOS PAC ID: 4284080292 Enrollment ID: I20231027000924 |