Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 117 2nd St West, Lakota, North Dakota |
Authorized Official Name and Position | Cathy Swenson (CEO) |
Authorized Official Contact | 7013224328 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 367 Mcville ND 58254-0367 Ph: (701) 247-2226 | 117 2nd St West Lakota ND 58344 Ph: (701) 247-2226 |
NPI Number | 1891859948 |
---|---|
Provider Enumeration Date | 12/21/2006 |
Last Update Date | 06/23/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891859948 | NPI | - | NPPES |
020720 | Other | ND | BLUE CROSS BLUE SHIELD |
011682 | Medicaid | ND | |
05158 | Medicaid | ND | |
301002 | Other | ND | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |