Healthcare Provider Details

I. General information

NPI: 1588763932
Provider Name (Legal Business Name): TRAILL DISTRICT HEALTH UNIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WEST CALEDONIA AVE
HILLSBORO ND
58045
US

IV. Provider business mailing address

114 W CALEDONIA AVE
HILLSBORO ND
58045
US

V. Phone/Fax

Practice location:
  • Phone: 701-636-4434
  • Fax: 701-636-5473
Mailing address:
  • Phone: 701-636-4434
  • Fax: 701-636-5473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number40
License Number StateND

VIII. Authorized Official

Name: BRENDA H STALLMAN
Title or Position: DIRECTOR
Credential: RN DIRECTOR
Phone: 701-636-4434