Healthcare Provider Details

I. General information

NPI: 1467682625
Provider Name (Legal Business Name): HILLSBORO MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 3RD ST SE
HILLSBORO ND
58045-4840
US

IV. Provider business mailing address

12 3RD ST SE
HILLSBORO ND
58045-4840
US

V. Phone/Fax

Practice location:
  • Phone: 701-636-3207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number992508
License Number StateND

VIII. Authorized Official

Name: TRAVIS SCHEVING
Title or Position: CFO
Credential:
Phone: 701-636-3212