| Prairie Assisted Living Services Llc | |
|
4914 Amberglow Dr Bismarck ND 58503-8851 | |
| (701) 226-9804 | |
| (701) 751-1307 |
| Full Name | Prairie Assisted Living Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4914 Amberglow Dr, Bismarck, North Dakota |
| Authorized Official Name and Position | Tisha Scheuer (OWNER) |
| Authorized Official Contact | 7012269804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Assisted Living Services Llc 4914 Amberglow Dr Bismarck ND 58503-8851 Ph: (701) 226-9804 | Prairie Assisted Living Services Llc 4914 Amberglow Dr Bismarck ND 58503-8851 Ph: (701) 226-9804 |
| NPI Number | 1033475868 |
|---|---|
| Provider Enumeration Date | 04/05/2012 |
| Last Update Date | 05/22/2019 |
| Medicare PECOS PAC ID | 4082861075 |
|---|---|
| Medicare Enrollment ID | O20120827000480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033475868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tisha Scheuer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093292815 PECOS PAC ID: 4789928219 Enrollment ID: I20181210002898 |
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