Healthcare Provider Details

I. General information

NPI: 1659333425
Provider Name (Legal Business Name): ASHLEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 1ST AVE SE
KULM ND
58456-7221
US

IV. Provider business mailing address

612 CENTER AVE N PO BOX 450
ASHLEY ND
58413-7013
US

V. Phone/Fax

Practice location:
  • Phone: 701-647-2722
  • Fax: 701-647-2722
Mailing address:
  • Phone: 701-288-3433
  • Fax: 701-288-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN HOEFT
Title or Position: CEO
Credential:
Phone: 701-288-3433