Spirit Lake Health Center | |
3883 74th Ave Ne Ft Totten ND 58301 | |
(701) 766-1612 | |
Not Available |
Full Name | Spirit Lake Health Center |
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Speciality | Clinic/center - Public Health, Federal |
Location | 3883 74th Ave Ne, Ft Totten, North Dakota |
Authorized Official Name and Position | Darren Martell (BUSINESS OFFICE MANAGER) |
Authorized Official Contact | 7017661600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Spirit Lake Health Center Po Box 309 3883 74th Ave Ne Fort Totten ND 58335-0309 Ph: () - | Spirit Lake Health Center 3883 74th Ave Ne Ft Totten ND 58301 Ph: (701) 766-1612 |
NPI Number | 1548323314 |
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Provider Enumeration Date | 12/19/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548323314 | NPI | - | NPPES |
01056 | Medicaid | ND | |
3503693 | Other | ND | NCPDP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP0904X | Clinic/center - Public Health, Federal | AU46983207 (* (Not Available)) | Primary |