FORT YATES INDIAN HEALTH SERVICE HOSPITAL NPI 1336286798

NPI Information

NPI: 1336286798
Provider Name: FORT YATES INDIAN HEALTH SERVICE HOSPITAL

Doing Business As: CANNONBALL CLINIC

Classification: Clinic/Center - 261QP0904X
Entity Type: Organization

Specialization: Public Health, Federal

Address:
6998 WEASEL STREET
CANNONBALL, ND
ZIP 58528
Phone: (701) 854-3831
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FORT YATES INDIAN HEALTH SERVICE HOSPITAL is a public health and federal clinic center in Cannonball, ND. FORT YATES INDIAN HEALTH SERVICE HOSPITAL NPI is 1336286798. The provider is registered as an organization entity type.
The provider Is Doing Business As Cannonball Clinic.

The provider's business location address is:

6998 WEASEL STREET
CANNONBALL, ND
ZIP 58528
Phone: (701) 854-3831
Fax: (701) 854-7411

The provider's authorized official is Jana Rhea Gipp .
The authorized official title is Chief Executive Officer and has the following contact phone number (701) 854-8211.

The enumeration date for this NPI number is 2/1/2007 and was last updated on 8/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP0904X	Clinic/Center	Public Health, Federal			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1459056	MEDICAID	NORTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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