| Glen Ullin Family Medical Clinic | |
|
602 Ash Ave E Glen Ullin ND 58631 | |
| (701) 584-2792 | |
| Not Available |
| Full Name | Glen Ullin Family Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 602 Ash Ave E, Glen Ullin, North Dakota |
| Authorized Official Name and Position | James Opdahl (CEO) |
| Authorized Official Contact | 7015842792 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glen Ullin Family Medical Clinic Po Box 367 Elgin ND 58533-0367 Ph: (701) 584-2792 | Glen Ullin Family Medical Clinic 602 Ash Ave E Glen Ullin ND 58631 Ph: (701) 584-2792 |
| NPI Number | 1003929944 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 08/12/2008 |
| Medicare PECOS PAC ID | 2466363981 |
|---|---|
| Medicare Enrollment ID | O20061130000152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003929944 | NPI | - | NPPES |
| 5177 | Medicaid | ND | |
| 06043003 | Other | ND | BLUE CROSS - RHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Glen Ullin Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 Ash Ave, Glen Ullin, ND 58631 Phone: 701-348-9175 Fax: 701-348-9177 |