Healthcare Provider Details

I. General information

NPI: 1083775688
Provider Name (Legal Business Name): CARRINGTON HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 4TH ST N
CARRINGTON ND
58421-0461
US

IV. Provider business mailing address

800 4TH ST N PO BOX 461
CARRINGTON ND
58421-1217
US

V. Phone/Fax

Practice location:
  • Phone: 701-652-3414
  • Fax: 701-652-3595
Mailing address:
  • Phone: 701-352-3141
  • Fax: 701-652-3595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number21
License Number StateND

VIII. Authorized Official

Name: KURT SARGENT
Title or Position: VP OPERATIONAL FINANCE
Credential:
Phone: 701-237-8064