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201 4th Ave Enderlin ND 58027-1325 | |
(701) 437-3320 | |
(701) 437-3323 |
Full Name | |
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Speciality | Clinic/Center |
Location | 201 4th Ave, Enderlin, North Dakota |
Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
Authorized Official Contact | 6053288380 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2168 Fargo ND 58107-2168 Ph: (701) 234-2119 | 201 4th Ave Enderlin ND 58027-1325 Ph: (701) 437-3320 |
NPI Number | 1285666271 |
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Provider Enumeration Date | 07/07/2006 |
Last Update Date | 01/23/2025 |
Medicare PECOS PAC ID | 8426967803 |
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Medicare Enrollment ID | O20221212001332 |
Identifier | Type | State | Issuer |
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1285666271 | NPI | - | NPPES |
591317900 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |