Healthcare Provider Details

I. General information

NPI: 1922959956
Provider Name (Legal Business Name): SOUTHWEST HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 2ND ST NW
BOWMAN ND
58623-4483
US

IV. Provider business mailing address

802 2ND ST NW
BOWMAN ND
58623-4483
US

V. Phone/Fax

Practice location:
  • Phone: 701-523-5555
  • Fax: 701-523-7107
Mailing address:
  • Phone: 701-523-5555
  • Fax: 701-523-7107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: TINA M MARMON
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 701-523-7150