Healthcare Provider Details

I. General information

NPI: 1477529030
Provider Name (Legal Business Name): SOUTHWEST HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 2ND ST NW SUITE 1
BOWMAN ND
58623
US

IV. Provider business mailing address

802 2ND ST NW SUITE 1
BOWMAN ND
58623
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 TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number5006P
License Number StateND

VIII. Authorized Official

Name: AMANDA LOUGHMAN
Title or Position: CFO
Credential:
Phone: 701-523-5555